• The state of vegetative homeostasis and cardiovascular system In children with diffuse nontoxic goiter 
To content

The state of vegetative homeostasis and cardiovascular system In children with diffuse nontoxic goiter 

SOVREMENNAYA PEDIATRIYA.2014.1(57):128-131; doi 10.15574/SP.2014.57.128 

The state of vegetative homeostasis and cardiovascular system In children with diffuse nontoxic goiter 

Yerokhina O. I., Budnik T. V., Geyvah L. О.

SU «Lugansk State Medical University», Lugansk, Ukraine

Lugansk Regional Children's Clinical Hospital, Lugansk, Ukraine 

Objective — to assess the state of autonomic regulation of the cardiovascular system in children with diffuse nontoxic goiter. 

Patients and methods. Total 603 children aged 6–16 years were examined. Research of heart rate variability (HRV) was performed in 70 children (average age 9.3 years): 46 children with goiter, a control group — 24 children with the same age and gender with no signs of thyroid disease, acute and chronic diseases. The size and structure of the thyroid were assessed using ultrasonography (Aloka SSD-unit 1400 linear transducer frequency 7.5 MHz) and compared with normative data, WHO, 2001. The wave structure of HRV was studied according to the recommendations of the working group of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996) on the computer electrocardiographic complex «Cardiolife», version 1.2 хх. 

Results. Children with goiter more often had functional disorders of the cardiovascular and autonomic nervous systems. Stress tests have caused sinus tachycardia with the achievement of maximum heart rate of 46 (100%) of the patients. We have found out the dysfunction of autonomic nervous system in these children. They had significant increase in sympathetic activity 2 (4.4%) in the initial vegetative tonus and low level of sympathetic activity 10 (21.7%), significant increase in sympathetic activity 12 (26.1%) after stress tests and reduced parasympathetic activity. 

Conclusion. Violations of autonomic regulation may be one of the possible mechanisms to reduce the adaptation process to the lack of iodine in the environment and the increased risk of cardiovascular disease in children with thyroid diseases. 

Key words: goiter, children, heart rate variability, autonomic nervous system. 

REFERENCES

1. Клиническая эндокринология: руководство. Под ред НТ Старковой. 3-е изд. СПб, Питер. 2002: 576. Серия «Спутник врача».

2. Сыч ЮП, Калашников ВЮ, Сыркин АЛ, Мельниченко ГА. 2003. Нарушения функционального состояния сердечно-сосудистой системы при субклиническом гипотиреозе. Клиническая медицина. 11: 4—9.

3. Петунина НА. 2006. Особенности терапии заболеваний щитовидной железы у пациентов с кардиальной патологией. Новости медицины и фармации. 6(188): 6—7.

4. Сысоева НА. 2005. Роль спектрального анализа вариабельности ритма сердца в оценке состояния вегетативной нервной системы у детей с патологией щитовидной железы в условиях санатория. Укр мед часопис. 4(48): 70—73.

5. Шульгин ВИ. 2009. Кардиолаб ВСР. Метод рек по анализу вариабельности сердечного ритма. Х: 66.

6. Яблучанский НИ, Мартыненко АВ. 2010. Вариабельность сердечного ритма в помощь практическому врачу. Х: 131.

7. Autonomic system with two subdivisions: the sympathetic division and the parasympathetic division. Hormonal control of blood pressure, physiological and clinical use. Task Force of European Society of Cardiological and The North American Society of Pacing and electrophysiology. Eur Heart J. 1996. 17;3: 354—381.