• Features of cardiovascular systems functional reserves according to a bicycle stress test in children with primary hypertension and magnesium deficiency and correction of revealed violations

Features of cardiovascular systems functional reserves according to a bicycle stress test in children with primary hypertension and magnesium deficiency and correction of revealed violations

SOVREMENNAYA PEDIATRIYA.2017.1(81):92-98; doi 10.15574/SP.2017.81.92

Marushko Yu. V., Hyschak T. V.
Bogomolets National Medical University, Kyiv, Ukraine

Use of bicycle stress test (BST) is dynamics of patients treatment with primary arterial hypertension (PAH) makes it possible to assess the reaction of blood pressure (BP) in the dosed physical activity, to provide characterization exercise tolerance, processes myocardial oxygen consumption and myocardial reserves, which is important for control the effectiveness of therapy.

Objective. To improve the results of PAH treatment by including to standard drug regimen combined magnesium and pyridoxine (Magne-B6), and monitoring

the effectiveness of treatment with application of BST.

Materials and methods. The study involved 43 children with PAH (labile and stable I degree) aged 10–17 years. A general clinical examination, test Ruf'ye, BST, determination of magnesium in serum during complex treatment are conducted. The first group consisted of 18 children with the level of magnesium in the blood serum of <0.8 mmol/l, which to a standard treatment regimen was further added Magne-B6. The second group included 25 children with the level of magnesium in blood serum >0.8 mmol/L who received only standard treatment.

Results. In children of the first group were found lower values (p<0.05) of the functional heart reserves breakdown Ruf'ye`s test (14.93±1.02 and 10.63±0.81 points, respectively in group I and II) and BST, enhanced and wasteful use of myocardial reserve (HEWI — 0.24±0.01 c.u. in the first and 0.30±0.02 c.u. in the second group), reduced activity oxygen transport system (MOC — 35.50±0,18 mL/min/kg and 44.0±2.11 ml/min/kg in group I and II respectively). Against the background of complex treatment with Magne3B6 from 1–3 months improved results of daily monitoring of blood pressure (DMBP) and BST, increased level of magnesium in serum and exercise tolerance.

Conclusions. In children with PAH reduced myocardial functional reserves and their enhanced and wasteful expenditure during exercise are observed. Magnesium deficiency in children with PAH deepens the violation of adaptation cardiovascular exercise that manifested reduced functional reserve of the heart by Ruf'ye`s test, low level of performance overall efficiency and functional reserves for BST. The inclusion to standard treatment regimen for children with labile and stable PAH I degree the Magne3B6 improves outcomes. There is a decrease SBP fluctuations, that are provoked by physical activity, increased activity oxygen transport system, improves exercise tolerance.

Key words: children, primary hypertension, magnesium deficiency, bicycle stress test.

REFERENCES

1. Gischak TV, Marushko YuV, Zlobinets AS. 2013. Defitsit magniya i ego korrektsiya u detey s pervichnoy arterialnoy gipertenziey. Aktualnyie problemyi pediatrii: materialyi 17 s'ezda pediatrov Rossii, Moskva, 14—17 fevr. 2013 g. Moskva: 386.

2. Korovina NA, Tvorogova TM, Gavryushova LP. 2006.Primenenie preparatov magniya pri serdechno-sosudistyih zabolevaniyah u detey. Lechaschiy vrach. 3: 10—13.

3. Marushko YuV, Gischak TV. 2013. Effect of combined magnesium preparation on asthenic signs and sleep quality in children with essential hypertension. Sovremennaya pediatriya. 3(51): 94—99.

4. Marushko YuV, Gischak TV. 2012. Korektsiia nedostatnosti mahniiu u ditei ta pidlitkiv z astenichnym syndromom ta pervynnoiu arterialnoiu hipertenziieiu. Metodychni rekomendatsii dlia likariv. Kyiv: 30.

5. Marushko YuV, Gischak TV. 2014. Diagnostic and correction problem of reduced exercise tolerance in school age children. Sovremennaya pediatriya. 7(63): 12—16. doi 10.15574/SP.2014.63.34

6. Golf SW, Bender S, Gruttner J. 1998. On the significance of magnesium in extreme physical stress. Cardiovasc Drugs Ther. 12(2): 197—202. https://doi.org/10.1023/A:1007708918683; https://doi.org/10.1023/A:1007787328732; PMid:9794094

7. De Valk HW, Verkaaik R, van Rijn HJ et al. 1998. Oral magnesium supplementation in insulin-requiring Type 2 diabetic patients. Diabet Med. 15(6): 503—507. https://doi.org/10.1002/(SICI)1096-9136(199806)15:6<503::AID-DIA596>3.3.CO;2-D; https://doi.org/10.1002/(SICI)1096-9136(199806)15:6<503::AID-DIA596>3.0.CO;2-M

8. Finstad EW, Newhouse IJ, Lukaski HC et al. 2001. The effects of magnesium supplementation on exercise performance. Med Sci Sports Exerc. 33(3): 493—498. https://doi.org/10.1097/00005768-200103000-00024; PMid:11252079

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