ДИСПЛАЗИЯ СОЕДИНИТЕЛЬНОЙ ТКАНИ КАК ПОТЕНЦИАЛЬНЫЙ ФАКТОР РИСКА ЭЛЕКТРИЧЕСКОЙ НЕСТАБИЛЬНОСТИ МИОКАРДА У МОЛОДЫХ АТЛЕТОВ
Ключевые слова:
атлеты, дисплазия соединительной ткани, кардиореспираторная система, адаптация к нагрузкам, внезапная смерть
Аннотация
Цель: поиск потенциальной связи между степенью выраженности дисплазии соединительной ткани (ДСТ) и эффективностью адаптации кардиореспираторной системы (КРС)
к физическим нагрузкам у атлетов молодого возраста. Материалы и методы. Показатели КРС оценивались у 200 спортсменов в возрасте от 11 до 23 лет с помощью спировело-эргометрии и 12-канальной ЭКГ в покое, в течение и после нагрузочного теста. Выраженность ДСТ определялась в баллах согласно национальным рекомендациям. Результаты. Установлено, что 86 % спортсменов имели умеренную или выраженную степень системной ДСТ, которая ограничивает мобилизацию КРС для адаптации атлетов к нагрузкам и ассоциируется с нарушением реполяризации миокарда. Заключение. Результаты настоящего исследования показали, с одной стороны, что у атлетов с ДСТ имеют место определенные отклонения в электрической активности сердца в покое и при физической нагрузке. С другой стороны, спортсмены с ДСТ по отношению к атлетам без дисплазии имеют изначально меньшую экономизацию функции сердечно-сосудистой системы и значимо большее время восстановления после физических упражнений. Это означает, что ДСТ ограничивает мобилизацию КРС для адаптации атлетов к нагрузкам, особенно если нагрузки носят циклический характер.
Литература
1. Внезапная смерть при занятиях спортом у лиц молодого возраста / Ю.И. Пиголкин, А.П. Середа, М.А. Шилова [и др.] // Материалы International Scientific Conference Scientific Discoveries, 2016. – С. 264–270.
2. Клинические рекомендации российского научного медицинского общества терапевтов по диагностике, лечению и реабилитации пациентов с дисплазиями соединительной ткани (первый пересмотр) / А.И. Мартынов, Г.И. Нечаева, Е.В. Акатова, М.В. Вершинина [и др.] // Медицинский вестник Северного Кавказа. – 2018. – Т. 13, № 1.2 – С. 137–209. DOI: 10.14300/mnnc.2018.13037
3. Макаров, Л.М. Спорт и внезапная смерть у детей / Л.М. Макаров // Рос. вестник перинатологии и педиатрии. – 2017. – Т. 62, № 1. – С. 40–46. DOI: 10.21508/1027-4065-2017-62-1-40-46
4. Наследственные и многофакторные нарушения соединительной ткани у детей. Алгоритмы диагностики. Тактика ведения. Российские рекомендации / Л.Н. Аббакумова, В.Г. Арсентьев, С.Ф. Гнусаев [и др.] // Педиатр. – 2016. – Т. 7, № 2. – С. 5–39. DOI: 10.17816/PED725-39
5. Нечаева, Г.И. Дисплазия соединительной ткани: сердечно-сосудистые изменения, современные подходы к диагностике и лечению. / Г.И. Нечаева, А.И. Мартынов. – М.: ООО «Медицинское информационное агентство», 2017. – 399 с.
6. Судебно-медицинская характеристика причин внезапной смерти у лиц молодого возраста / Ю.И. Пиголкин, М.А. Шилова, Е.М. Кильдюшов [и др.] // Судебно-мед. экспертиза. – 2016. – Т. 5. – С. 4–9. DOI: 10.17116/sudmed20165954-9
7. A prospective study of sudden cardiac death among children and young adults / R.D. Bagnall, R.G. Weintraub, J. Ingles, J. Duflou [et al.] // New England Journal of Medicine. – 2016. – Vol. 374. – P. 2441–2452. DOI: 10.1056/NEJMoa1510687
8. ACC/AHA 2002 Guideline Update for Exercise Testing: Summary Article A Report of the American College of Cardiology American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines) / R.J. Gibbons [et al.] // Circulation. – 2002. – Vol. 106. – P. 1883–1892. DOI: 10.1161/01.CIR.0000034670.06526.15
9. Accuracy of the ECG for differential diagnosis between hypertrophic cardiomyopathy and athlete’s heart: comparison between the European Society of Cardiology (2010) and International (2017) criteria / A. Zorzi [et al.] // British Journal of Sports Medicine. – 2017. – Vol. 0. – P. 1–7. DOI: 10.1136/bjsports-2016-097438
10. Assessment of the 12-Lead ECG as a Screening Test for Detection of Cardiovascular Disease in Healthy General Populations of Young People (12–25 Years of Age): A Scientific Statement From the American Heart Association and the American College of Car-diology / B.J. Maron [et al.] // Circulation. – 2014. – Vol. 130, no. 15. – P. 1303–1334. DOI: 10.1161/CIR.0000000000000025
11. Bauce, B. Differences and similarities between arrhythmogenic right ventricular cardiomyopathy and athlete’s heart adaptations / B. Bauce [et al.] // British Journal of Sports Medicine. – 2010. – Vol. 44. – P. 148–154. DOI: 10.1136/bjsm.2007.042853
12. Corrado, D. Arrhythmogenic right ventricular cardiomyopathy / D. Corrado, M.S. Link, H.N. Calkins // New England Journal of Medicine. – 2017. – Vol. 376. – P. 61–72. DOI: 10.1056/NEJMra1509267
13. Electrical and structural adaptations of the paediatric athlete’s heart: a systematic review with metaanalysis / G. McClean [et al.] // British Journal of Sports Medicine. – 2018. – Vol. 52, no. 4. – P. 12–23. DOI: 10.1136/bjsports-2016-097052
14. Electrocardiographic features of arrhythmogenic right ventricular dysplasia / cardio-myopathy according to disease severity: a need to broaden diagnostic criteria / K. Nasir [et al.] // Circulation. – 2004. – Vol. 110. – P. 1527–1534. DOI: 10.1161/01.CIR.0000142293.60725.18
15. Etiology of sudden death in sports. Insights from a United Kingdom regional registry / G. Finocchiaro [et al.] // Journal of American College of Cardiology. – 2016. – Vol. 67, no. 18. – P. 2108–2115. DOI: 10.1016/j.jacc.2016.02.062
16. Kohla, P. Fibroblastmyocyte electrotonic coupling: Does it occur in nativecardiac tissue? / P. Kohla, R.G. Gourdie // Journal of Molecular and Cellular Cardiology. – 2014. – Vol. 70. – P. 37–46. DOI: 10.1016/j.yjmcc.2013.12.024
17. Outcomes in athletes with marked ECG repolarization abnormalities. / A. Pelliccia [et al.] // New England Journal of Medicine. – 2008. – Vol. 358. – P. 152–161. DOI: 10.1056/NEJMoa060781
18. Pelliccia, A. Athletes with abnormal repolarization pattern and structurally normal heart can participate in competitive sport / A. Pelliccia, F.M. DiPaolo // Journal of American College of Cardiology. – 2011. – Vol. 58. – P. 883–884. DOI: 10.1016/j.jacc.2011.05.016
19. Quinn, T.A. Cardiac Mechano-electric Coupling Research: Fifty Years of Progress and Scientific Innovation / T.A. Quinn, P. Kohl, U. Ravens // Progress in Biophysics and Molecular Biology. – 2014. – Vol. 115, no. 2-3. – P. 71–75. DOI: 10.1016/j.pbiomolbio.2014.06.007
20. Recommendations for participation in competitive and leisure time sport in athletes with cardiomyopathies, myocarditis, and pericarditis: position statement of the Sport Cardiology Section of the European Association of Preventive Cardiology (EAPC) / A. Pelliccia [et al.] // European Heart Journal. –2018. – Vol. 0. – P. 1–18. DOI: 10.1093/eurheartj/ehy730
2. Martynov A.I., Nechayeva G.I., Akatova E.V. et al. [Clinical Recommendations of the Russian Scientific Medical Society of Therapists in the Diagnosis, Treatment and Rehabilitation of Patients with Connective Tissue Dysplasia (First Review)]. Meditsinskiy vestnik Severnogo Kavkaza [Medical Bulletin of the North Caucasus], 2018, vol. 13, no. 1.2, pp. 137–209. (in Russ.) DOI: 10.14300/mnnc.2018.13037
3. Makarov L.M. [Sport and Sudden Death in Children]. Rossiyskiy vestnik perinatologii i pediatrii [Russian Bulletin of Perinatology and Pediatrics], 2017, vol. 62, no. 1, pp. 40–46. (in Russ.) DOI: 10.21508/1027-4065-2017-62-1-40-46
4. Abbakumova L.N., Arsent’yev V.G., Gnusayev S.F. et al. [Hereditary and Multifactorial Disorders of Connective Tissue in Children. Diagnostic Algorithms. Tactics of Reference. Russian Recommendations]. Pediatr [Pediatrician], 2016, vol. 7, no. 2, pp. 5–39. (in Russ.) DOI: 10.17816/PED725-39
5. Nechayeva G.I., Martynov A.I. Displaziya soyedinitel’noy tkani: serdechnososudistyye izmeneniya, sovremennyye podkhody k diagnostike i lecheniyu [Connective Tissue Dysplasia. Cardiovascular Changes, Modern Approaches to Diagnosis and Treatment]. Moscow, Medical Information Agency LLC Publ., 2017. 399 p.
6. Pigolkin Yu.I., Shilova M.A., Kil’dyushov E.M. et al. [Forensic Medical Characteristics of the Causes of Sudden Death in Young People]. Sudebno-meditsinskaya ekspertiza [Forensic Medical Examination], 2016, vol. 5, pp. 4–9. (in Russ.) DOI: 10.17116/sudmed20165954-9
7. Bagnall R.D., Weintraub R.G., Ingles J. et al. A Prospective Study of Sudden Cardiac Death Among Children and Young Adults. New England Journal of Medicine, 2016, vol. 374, pp. 2441–2452. DOI: 10.1056/NEJMoa1510687
8. Gibbons et al. ACC/AHA 2002 Guideline Update for Exercise Testing: Summary Article a Report of the American College of Cardiology American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines). Circulation, 2002, vol. 106, pp. 1883–1892. DOI: 10.1161/01.CIR.0000034670.06526.15
9. Zorzi A. et al. Accuracy of the ECG for Differential Diagnosis Between Hypertrophic Cardio-myopathy and Athlete’s Heart: Comparison Between the European Society of Cardiology (2010)
and International (2017) Criteria. British Journal of Sports Medicine, 2017, vol. 0, pp. 1–7. DOI: 10.1136/bjsports-2016-097438
10. Maron B.J. et al. Assessment of the 12-Lead ECG as a Screening Test for Detection of Cardio-vascular Disease in Healthy General Populations of Young People (12−25 Years of Age): A Scientific Statement From the American Heart Association and the American College of Cardiology. Circulation, 2014, vol. 130, no. 15, pp. 1303–1334. DOI: 10.1161/CIR.0000000000000025
11. Bauce B. et al. Differences and Similarities Between Arrhythmogenic Right Ventricular Cardiomyopathy and Athlete’s Heart Adaptations. British Journal of Sports Medicine, 2010, vol. 44,
pp. 148–154. DOI: 10.1136/bjsm.2007.042853
12. Corrado D., Link M.S., Calkins H.N. Arrhythmogenic Right Ventricular Cardiomyopathy. New England Journal of Medicine, 2017, vol. 376, pp. 61–72. DOI: 10.1056/NEJMra1509267
13. McClean G. et al. Electrical and Structural Adaptations of the Paediatric Athlete’s Heart: a Systematic Review with Metaanalysis. British Journal of Sports Medicine, 2018, vol. 52, no. 4, pp. 12–23. DOI: 10.1136/bjsports-2016-097052
14. Nasir K. et al. Electrocardiographic Features of Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy According to Disease Severity: a Need to Broaden Diagnostic Criteria. Circulation, 2004, vol. 110, pp. 1527–1534. DOI: 10.1161/01.CIR.0000142293.60725.18
15. Finocchiaro G. et al. Etiology of Sudden Death in Sports. Insights from a United Kingdom Regional Registry. Journal of American College of Cardiology, 2016, vol. 67, no. 18, pp. 2108–2115. DOI: 10.1016/j.jacc.2016.02.062
16. Kohla P., Gourdie R.G. Fibroblast-Myocyte Electrotonic Coupling: Does it Occur in Nativecardiac Tissue? Journal of Molecular and Cellular Cardiology, 2014, vol. 70, pp. 37–46. DOI: 10.1016/j.yjmcc.2013.12.024
17. Pelliccia A. et al. Outcomes in Athletes with Marked ECG Repolarization Abnormalities. New England Journal of Medicine, 2008, vol. 358, pp. 152–161. DOI: 10.1056/NEJMoa060781
18. Pelliccia A., DiPaolo F.M. Athletes with Abnormal Repolarization Pattern and Structurally Normal Heart Can Participate in Competitive Sport. Journal of American College of Cardiology, 2011, vol. 58, pp. 883–884. DOI: 10.1016/j.jacc.2011.05.016
19. Quinn T.A., Kohl P., Ravens U. Cardiac Mechano-Electric Coupling Research: Fifty Years of Progress and Scientific Innovation. Progress in Biophysics and Molecular Biology, 2014, vol. 115,
no. 2–3, pp. 71–75. DOI: 10.1016/j.pbiomolbio.2014.06.007
20. Pelliccia A. et al. Recommendations for Participation in Competitive and Leisure Time Sport in Athletes with Cardiomyopathies, Myocarditis, and Pericarditis: Position Statement of the Sport Cardiology Section of the European Association of Preventive Cardiology (EAPC). European Heart Journal, 2018, vol. 0, pp. 1–18. DOI: 10.1093/eurheartj/ehy730
2. Клинические рекомендации российского научного медицинского общества терапевтов по диагностике, лечению и реабилитации пациентов с дисплазиями соединительной ткани (первый пересмотр) / А.И. Мартынов, Г.И. Нечаева, Е.В. Акатова, М.В. Вершинина [и др.] // Медицинский вестник Северного Кавказа. – 2018. – Т. 13, № 1.2 – С. 137–209. DOI: 10.14300/mnnc.2018.13037
3. Макаров, Л.М. Спорт и внезапная смерть у детей / Л.М. Макаров // Рос. вестник перинатологии и педиатрии. – 2017. – Т. 62, № 1. – С. 40–46. DOI: 10.21508/1027-4065-2017-62-1-40-46
4. Наследственные и многофакторные нарушения соединительной ткани у детей. Алгоритмы диагностики. Тактика ведения. Российские рекомендации / Л.Н. Аббакумова, В.Г. Арсентьев, С.Ф. Гнусаев [и др.] // Педиатр. – 2016. – Т. 7, № 2. – С. 5–39. DOI: 10.17816/PED725-39
5. Нечаева, Г.И. Дисплазия соединительной ткани: сердечно-сосудистые изменения, современные подходы к диагностике и лечению. / Г.И. Нечаева, А.И. Мартынов. – М.: ООО «Медицинское информационное агентство», 2017. – 399 с.
6. Судебно-медицинская характеристика причин внезапной смерти у лиц молодого возраста / Ю.И. Пиголкин, М.А. Шилова, Е.М. Кильдюшов [и др.] // Судебно-мед. экспертиза. – 2016. – Т. 5. – С. 4–9. DOI: 10.17116/sudmed20165954-9
7. A prospective study of sudden cardiac death among children and young adults / R.D. Bagnall, R.G. Weintraub, J. Ingles, J. Duflou [et al.] // New England Journal of Medicine. – 2016. – Vol. 374. – P. 2441–2452. DOI: 10.1056/NEJMoa1510687
8. ACC/AHA 2002 Guideline Update for Exercise Testing: Summary Article A Report of the American College of Cardiology American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines) / R.J. Gibbons [et al.] // Circulation. – 2002. – Vol. 106. – P. 1883–1892. DOI: 10.1161/01.CIR.0000034670.06526.15
9. Accuracy of the ECG for differential diagnosis between hypertrophic cardiomyopathy and athlete’s heart: comparison between the European Society of Cardiology (2010) and International (2017) criteria / A. Zorzi [et al.] // British Journal of Sports Medicine. – 2017. – Vol. 0. – P. 1–7. DOI: 10.1136/bjsports-2016-097438
10. Assessment of the 12-Lead ECG as a Screening Test for Detection of Cardiovascular Disease in Healthy General Populations of Young People (12–25 Years of Age): A Scientific Statement From the American Heart Association and the American College of Car-diology / B.J. Maron [et al.] // Circulation. – 2014. – Vol. 130, no. 15. – P. 1303–1334. DOI: 10.1161/CIR.0000000000000025
11. Bauce, B. Differences and similarities between arrhythmogenic right ventricular cardiomyopathy and athlete’s heart adaptations / B. Bauce [et al.] // British Journal of Sports Medicine. – 2010. – Vol. 44. – P. 148–154. DOI: 10.1136/bjsm.2007.042853
12. Corrado, D. Arrhythmogenic right ventricular cardiomyopathy / D. Corrado, M.S. Link, H.N. Calkins // New England Journal of Medicine. – 2017. – Vol. 376. – P. 61–72. DOI: 10.1056/NEJMra1509267
13. Electrical and structural adaptations of the paediatric athlete’s heart: a systematic review with metaanalysis / G. McClean [et al.] // British Journal of Sports Medicine. – 2018. – Vol. 52, no. 4. – P. 12–23. DOI: 10.1136/bjsports-2016-097052
14. Electrocardiographic features of arrhythmogenic right ventricular dysplasia / cardio-myopathy according to disease severity: a need to broaden diagnostic criteria / K. Nasir [et al.] // Circulation. – 2004. – Vol. 110. – P. 1527–1534. DOI: 10.1161/01.CIR.0000142293.60725.18
15. Etiology of sudden death in sports. Insights from a United Kingdom regional registry / G. Finocchiaro [et al.] // Journal of American College of Cardiology. – 2016. – Vol. 67, no. 18. – P. 2108–2115. DOI: 10.1016/j.jacc.2016.02.062
16. Kohla, P. Fibroblastmyocyte electrotonic coupling: Does it occur in nativecardiac tissue? / P. Kohla, R.G. Gourdie // Journal of Molecular and Cellular Cardiology. – 2014. – Vol. 70. – P. 37–46. DOI: 10.1016/j.yjmcc.2013.12.024
17. Outcomes in athletes with marked ECG repolarization abnormalities. / A. Pelliccia [et al.] // New England Journal of Medicine. – 2008. – Vol. 358. – P. 152–161. DOI: 10.1056/NEJMoa060781
18. Pelliccia, A. Athletes with abnormal repolarization pattern and structurally normal heart can participate in competitive sport / A. Pelliccia, F.M. DiPaolo // Journal of American College of Cardiology. – 2011. – Vol. 58. – P. 883–884. DOI: 10.1016/j.jacc.2011.05.016
19. Quinn, T.A. Cardiac Mechano-electric Coupling Research: Fifty Years of Progress and Scientific Innovation / T.A. Quinn, P. Kohl, U. Ravens // Progress in Biophysics and Molecular Biology. – 2014. – Vol. 115, no. 2-3. – P. 71–75. DOI: 10.1016/j.pbiomolbio.2014.06.007
20. Recommendations for participation in competitive and leisure time sport in athletes with cardiomyopathies, myocarditis, and pericarditis: position statement of the Sport Cardiology Section of the European Association of Preventive Cardiology (EAPC) / A. Pelliccia [et al.] // European Heart Journal. –2018. – Vol. 0. – P. 1–18. DOI: 10.1093/eurheartj/ehy730
References
Pigolkin Yu.I., Sereda A.P., Shilova M.A. et al. [Sudden Death During Sports in Young People]. Materialy International Scientific Conference Scientific Discoveries [Materials of the International Scientific Conference Scientific Discoveries], 2016, pp. 264–270. (in Russ.)2. Martynov A.I., Nechayeva G.I., Akatova E.V. et al. [Clinical Recommendations of the Russian Scientific Medical Society of Therapists in the Diagnosis, Treatment and Rehabilitation of Patients with Connective Tissue Dysplasia (First Review)]. Meditsinskiy vestnik Severnogo Kavkaza [Medical Bulletin of the North Caucasus], 2018, vol. 13, no. 1.2, pp. 137–209. (in Russ.) DOI: 10.14300/mnnc.2018.13037
3. Makarov L.M. [Sport and Sudden Death in Children]. Rossiyskiy vestnik perinatologii i pediatrii [Russian Bulletin of Perinatology and Pediatrics], 2017, vol. 62, no. 1, pp. 40–46. (in Russ.) DOI: 10.21508/1027-4065-2017-62-1-40-46
4. Abbakumova L.N., Arsent’yev V.G., Gnusayev S.F. et al. [Hereditary and Multifactorial Disorders of Connective Tissue in Children. Diagnostic Algorithms. Tactics of Reference. Russian Recommendations]. Pediatr [Pediatrician], 2016, vol. 7, no. 2, pp. 5–39. (in Russ.) DOI: 10.17816/PED725-39
5. Nechayeva G.I., Martynov A.I. Displaziya soyedinitel’noy tkani: serdechnososudistyye izmeneniya, sovremennyye podkhody k diagnostike i lecheniyu [Connective Tissue Dysplasia. Cardiovascular Changes, Modern Approaches to Diagnosis and Treatment]. Moscow, Medical Information Agency LLC Publ., 2017. 399 p.
6. Pigolkin Yu.I., Shilova M.A., Kil’dyushov E.M. et al. [Forensic Medical Characteristics of the Causes of Sudden Death in Young People]. Sudebno-meditsinskaya ekspertiza [Forensic Medical Examination], 2016, vol. 5, pp. 4–9. (in Russ.) DOI: 10.17116/sudmed20165954-9
7. Bagnall R.D., Weintraub R.G., Ingles J. et al. A Prospective Study of Sudden Cardiac Death Among Children and Young Adults. New England Journal of Medicine, 2016, vol. 374, pp. 2441–2452. DOI: 10.1056/NEJMoa1510687
8. Gibbons et al. ACC/AHA 2002 Guideline Update for Exercise Testing: Summary Article a Report of the American College of Cardiology American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines). Circulation, 2002, vol. 106, pp. 1883–1892. DOI: 10.1161/01.CIR.0000034670.06526.15
9. Zorzi A. et al. Accuracy of the ECG for Differential Diagnosis Between Hypertrophic Cardio-myopathy and Athlete’s Heart: Comparison Between the European Society of Cardiology (2010)
and International (2017) Criteria. British Journal of Sports Medicine, 2017, vol. 0, pp. 1–7. DOI: 10.1136/bjsports-2016-097438
10. Maron B.J. et al. Assessment of the 12-Lead ECG as a Screening Test for Detection of Cardio-vascular Disease in Healthy General Populations of Young People (12−25 Years of Age): A Scientific Statement From the American Heart Association and the American College of Cardiology. Circulation, 2014, vol. 130, no. 15, pp. 1303–1334. DOI: 10.1161/CIR.0000000000000025
11. Bauce B. et al. Differences and Similarities Between Arrhythmogenic Right Ventricular Cardiomyopathy and Athlete’s Heart Adaptations. British Journal of Sports Medicine, 2010, vol. 44,
pp. 148–154. DOI: 10.1136/bjsm.2007.042853
12. Corrado D., Link M.S., Calkins H.N. Arrhythmogenic Right Ventricular Cardiomyopathy. New England Journal of Medicine, 2017, vol. 376, pp. 61–72. DOI: 10.1056/NEJMra1509267
13. McClean G. et al. Electrical and Structural Adaptations of the Paediatric Athlete’s Heart: a Systematic Review with Metaanalysis. British Journal of Sports Medicine, 2018, vol. 52, no. 4, pp. 12–23. DOI: 10.1136/bjsports-2016-097052
14. Nasir K. et al. Electrocardiographic Features of Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy According to Disease Severity: a Need to Broaden Diagnostic Criteria. Circulation, 2004, vol. 110, pp. 1527–1534. DOI: 10.1161/01.CIR.0000142293.60725.18
15. Finocchiaro G. et al. Etiology of Sudden Death in Sports. Insights from a United Kingdom Regional Registry. Journal of American College of Cardiology, 2016, vol. 67, no. 18, pp. 2108–2115. DOI: 10.1016/j.jacc.2016.02.062
16. Kohla P., Gourdie R.G. Fibroblast-Myocyte Electrotonic Coupling: Does it Occur in Nativecardiac Tissue? Journal of Molecular and Cellular Cardiology, 2014, vol. 70, pp. 37–46. DOI: 10.1016/j.yjmcc.2013.12.024
17. Pelliccia A. et al. Outcomes in Athletes with Marked ECG Repolarization Abnormalities. New England Journal of Medicine, 2008, vol. 358, pp. 152–161. DOI: 10.1056/NEJMoa060781
18. Pelliccia A., DiPaolo F.M. Athletes with Abnormal Repolarization Pattern and Structurally Normal Heart Can Participate in Competitive Sport. Journal of American College of Cardiology, 2011, vol. 58, pp. 883–884. DOI: 10.1016/j.jacc.2011.05.016
19. Quinn T.A., Kohl P., Ravens U. Cardiac Mechano-Electric Coupling Research: Fifty Years of Progress and Scientific Innovation. Progress in Biophysics and Molecular Biology, 2014, vol. 115,
no. 2–3, pp. 71–75. DOI: 10.1016/j.pbiomolbio.2014.06.007
20. Pelliccia A. et al. Recommendations for Participation in Competitive and Leisure Time Sport in Athletes with Cardiomyopathies, Myocarditis, and Pericarditis: Position Statement of the Sport Cardiology Section of the European Association of Preventive Cardiology (EAPC). European Heart Journal, 2018, vol. 0, pp. 1–18. DOI: 10.1093/eurheartj/ehy730
Опубликован
2020-01-28
Как цитировать
Тимохина, В., Мехдиева, К., & Бляхман, Ф. (2020). ДИСПЛАЗИЯ СОЕДИНИТЕЛЬНОЙ ТКАНИ КАК ПОТЕНЦИАЛЬНЫЙ ФАКТОР РИСКА ЭЛЕКТРИЧЕСКОЙ НЕСТАБИЛЬНОСТИ МИОКАРДА У МОЛОДЫХ АТЛЕТОВ. Человек. Спорт. Медицина, 19(4), 125-132. https://doi.org/10.14529/hsm190415
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