Laser therapy in the correction of systolic left ventricle myocardial dysfunction in children and adolescents

Cover Page
Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract


Background. Due to the need to develop a complex therapy for children and adolescents with functional heart disorders, rhythm disorders against the background of the restructuring of the autonomic regulation of heart activity, a very important section is to study the possibility of using laser therapy in the correction of left ventricular (LV) systolic function disorders in patients. One of these methods is laser therapy. The research hypothesis suggests that using laser stimulation of active points, it is possible to restore the synchronicity of contractile activity of the contralateral segments of the LV myocardium.

Aims: To study the effect of laser correction on the functional state of the LV myocardium in children and adolescents and the vegetative status, which leads to the formation of functional changes in the heart in children and adolescents, necessary for the development of complex therapy for systolic dysfunction.

Material and methods. The study involved 60 children and adolescents aged 12–16 years. Patients were divided into two groups: group 1 (n = 30) – children aged 12–14 years; 15 girls and 15 boys. Group 2 (n = 30) — teenagers 14–16 years old. The sample also includes 15 girls and 15 boys. Evaluation of contractile activity disorders was performed with ECHO-KG in the parasternal position along the long axis. The thickness of the interventricular septum (LVM) and the posterior wall of the left ventricle (LVL) in systole and diastole was evaluated. Assessment of the vegetative status was performed by cardiointervalography in the study of daily ECG recording. Treatment was performed by laser correction according to the standard method: 10 daily sessions with laser stimulation of trigger zones in the shoulder and forearm – extraceptive (1000 Hz, 2 min) and proprioceptive (50 Hz, 2 min), as well as in the direct projection of the heart (5 Hz, 2 min). Аctivation рoints: 4th intercostal space at the left edge of the sternum (5 Hz, 5 min), carotid sinus (left carotid artery pulsation zone — 50 Hz, 2 min), to the left of the spine at the level of the left corner of the scapula (5 Hz, 2 min). After laser therapy, repeated ECHO-cardiography was performed to assess the dynamics of LV systolic function in children and adolescents.

Results. Of the 60 children examined, 24% of children aged 12 to 14 years had symmetrical thickening of the myocardium of the LV and LVL, compared to 67% in the group aged 15 to 16 years. In the group from 12 to 14 years, 43% of children had asynchronous systolic dysfunction of the anterior-septal type. The remaining children (33%) had asynchronous posterobasal systolic dysfunction. In the group of children aged 14 to 16 years, asynchronous systolic dysfunction in the anterior-septal type was detected in 23%, and in the posterior-basal type — in 1%. According to the results of cardiointervalography, hypersympathicotonia was detected in 72% of children aged 14–16 years. Mixed type of vegetative dystonia was observed in 25% of cases in this age group. Hyperparasympathicotonia was detected in 3% of the examined patients. In children aged 12–14 years, a mixed type of hyperactivity was detected in 79% of cases. Hyperparasympathicotonia was observed in 15% of the examined patients, against 6% of patients with hypersympathicotonia. All children identified moderate stress tension autonomic regulation, and baroreflexes regulation was not violated. After laser therapy using a standardized method, the following results were obtained: in the group of children aged 12–14 years, symmetrical thickening of the contralateral segments of the myocardium was detected in 72% of children. In children aged 15–16, resynchronization was achieved in 85% of patients.

Conclusions. Laser therapy in children and adolescents with functional disorders of the contractile activity of the LV myocardium in the group of children 12–14 years old led to resynchronization of contraction of contralateral segments and a change in autonomic reactivity mainly to parasympathicotonic.


Full Text

Restricted Access

About the authors

Alexander V. Kotovsky

Institute of Advanced Medical Training — branch of the Russian Medical Academy of Continuing Professional Education

Author for correspondence.
Email: kotovskij@list.ru
ORCID iD: 0000-0001-9402-6006
SPIN-code: 1367-5977

Russian Federation, Penza

PhD

Marina Yu. Gerasimenko

Russian Medical Academy of Continuous Professional Education

Email: kotovskij@list.ru
ORCID iD: 0000-0002-1741-7246
SPIN-code: 7625-6452

Russian Federation, Moscow

DSc., Prof.

Villory I. Strukov

Institute of Advanced Medical Training — branch of the Russian Medical Academy of Continuing Professional Education

Email: kotovskij@list.ru
ORCID iD: 0000-0003-0959-3933
SPIN-code: 6775-2841

Russian Federation, Penza

DSc., Prof.

References

  1. Malyshenko NM, Popova NS. Hormones and neuropeptides in integrative processes. Uspekhi fiziologicheskikh nauk. 1990;21(2):90–110. (In Russ).
  2. Medvedev VL, Kulikov AM. Anatomical and physiological characteristics of adolescents (adolescent medicine): the management for doctors. Ed. by L.I. Levin. Saint Petersburg: Spetslit; 1999. P. 5–31. (In Russ).
  3. Delgado V, Bax JJ. Assessment of systolic dyssynchrony for cardiac resynchronization therapy is clinically useful. Circulation. 2011;123(6):640–655. doi: 10.1161/CIRCULATIONAHA.110.954404
  4. Yu CM, Hayes DL. Cardiac resynchronization therapy: state of the art 2013. Eur Heart J. 2013;34(19):1396–1403. doi: 10.1093/eurheartj/ehs454
  5. Iliceto S, Caiati C, Ricci A, et al. Prediction of cardiac events after uncomplicated myocardial infarction by cross-sectional echocardiography during transesophageal atrial pacing. Intern. Int J Cardiol. 1990;28(1):95–103. doi: 10.1016/0167-5273(90)90013-u
  6. Vorobyov AS, Zimina VYu. Echocardiography in children and adults: a guide for doctors. Saint Petersburg: Spetslit; 2015. 590 p. (In Russ).
  7. Alyokhin MN. Ultrasound methods for assessing myocardial deformity and their clinical significance. Moscow: Vidar-M; 2012. 88 p. (In Russ).
  8. Zakharova IN, Tvorogova TM, PshenichniKova II. Current guidelines for diagnosis and treatment of vegetative dystonia in children and adolescents. Medical council. 2016;(16):116–123. (In Russ). doi: 10.21518/2079-701X-2016-16-116-123

Supplementary files

Supplementary Files Action
1.
Segments of the myocardium of the left ventricle in the parasternal long axis positions: 1 - anterior septal basal segment, 4 - posterior basal segment. RV - right ventricle, LV - left ventricle, Ao - aorta, LA - left atrium.

Download (44KB) Indexing metadata

Statistics

Views

Abstract - 50

PDF (Russian) - 0

Cited-By


Article Metrics

Metrics Loading ...

Refbacks

  • There are currently no refbacks.

Copyright (c) 2020 Eco-Vector



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies