smjournalСпортивная медицина: наука и практикаSports medicine: research and practice2223-25242587-9014NEICON10.17238/ISSN2223-2524.2020.2.48smjournal-202Research ArticleФИЗИОЛОГИЯ И БИОХИМИЯ СПОРТАSPORTS PHYSIOLOGY AND BIOCHEMISTRYПрогностическое значение индекса массы тела в диагностике внезапной сердечной смертиPrognostic value of body mass index in the diagnosis of sudden cardiac deathhttps://orcid.org/0000-0001-5370-4931ПиголкинЮ. И.PigolkinYu. I.

Пиголкин Юрий Иванович, заведующий кафедрой судебной медицины, член-корр. РАН, проф., д.м.н.  

Москва

Yuriy I. Pigolkin, M.D., D.Sc. (Medicine), Prof., Corresponding Member of the Russian Academy of Sciences, Head of the Department of Forensic Medicine

Moscow

https://orcid.org/0000-0003-0107-9649ЗахаровС. Н.ZakharovS. N.

Захаров Святослав Николаевич, ассистент кафедры судебной медицины 

Москва

Svyatoslav N. Zakharov, M.D., Assistant of the Department of Forensic Medicine

Moscow

https://orcid.org/0000-0002-8502-1331БерезовскийД. П.BerezovskiyD. P.

Березовский Дмитрий Павлович, профессор кафедры судебной медицины, проф., д.м.н. 

+7(938)160-96-81 

Москва

Dmitriy P. Berezovskiy, M.D., D.Sc. (Medicine), Prof., Professor of the Department of Forensic Medicine of

Moscow

dpb@mail.ruhttps://orcid.org/0000-0002-4349-5897БачуринС. С.BachurinS. S.

Бачурин Станислав Сергеевич, старший преподаватель кафедры общей и клинической биохимии №2, к.х.н. 

Ростов-на-Дону

Stainslav S. Bachurin, Ph.D. (Chemistry), Senior Lecturer of the Department of General and clinical biochemistry N2

Rostov-on-Don

ФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский университет), Министерство здравоохранения РФРоссияSechenov First Moscow State Medical University (Sechenov University)Russian FederationФГБОУ ВО Ростовский государственный медицинский университет,Министерство здравоохранения РФРоссияRostov State Medical UniversityRussian Federation2020140920201024854Copyright © Пиголкин Ю.И., Захаров С.Н., Березовский Д.П., Бачурин С.С., 20202020Пиголкин Ю.И., Захаров С.Н., Березовский Д.П., Бачурин С.С.Pigolkin Y.I., Zakharov S.N., Berezovskiy D.P., Bachurin S.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.smjournal.ru/jour/article/view/202

Цель исследования: определить значение индекса массы тела (ИМТ) для лиц, страдающих заболеваниями сердечно-сосудистой системы (ССС) для прогноза внезапной сердечной смерти (ВСС). Материалы и методы: Изучен архивный материал медицинских организаций: 1) ФГБУ «Федеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий ФМБА России» (I группа сравнения). В исследование были включены молодые спортсмены (N=603) как без патологии ССС, так и те, у кого выявлены заболевания в результате диспансерного осмотра; 2) танатологического отдела Бюро судебно-медицинской экспертизы (СМЭ) (II группа сравнения). Выборка (N=30) представлена случаями ВСС, обусловленными ишемической болезнью сердца (ИБС); 3) кардиохирургического отделения Больницы скорой медицинской помощи (БСМП) (III группа сравнения). Выборка (N=81) представлена случаями острого коронарного синдрома (ОКС); 4) кардиохирургического отделения клиники Ростовского государственного медицинского университета (IV группа сравнения).Выборка (N=95) представлена случаями ИБС у пациентов, находившихся на плановом лечении. В каждой группе сравнения определяли ИМТ. Результаты: В I группе сравнения ИМТ составил 22,10±1,67кг/м2,во II – 18,7±0,45 кг/м2, в III – 28,01±0,58 кг/м2, в IV– 28,66±0,47 кг/м2.Рассчитанное значение χ2 как для всех групп, так и при их попарном сравнении, оказалось статистически достоверным (p<0,01), что позволяет утверждать о наличии тесной связи ожирения с повышенным риском развития ИБС. Выводы: связи между ИМТ и наличием патологии ССС в I группе сравнения (спортсмены) не установлено. Для II – IV групп ИМТ находится в статистически значимой ассоциации с патологией ССС.

Objective: to determine the value of the body mass index (BMI) in cardiovascular patients for the sudden cardiac death (SCD) prediction. Materials and methods: we analyzed the medical archives of: 1) the Federal Research Clinical Center for Specialized Types of Healthcare and Medical Technologies, the Federal Biomedical Agency of Russia (comparison group I). The study included young athletes (N=603) without cardiovascular pathology, as well as those with cardiovascular diseases diagnosed in a medical examination; 2) Thanatological Department of the Bureau of Forensic Medical Examination (comparison group II). The sample (N=30) is represented by coronary heart disease (CHD) associated SCD cases; 3) the cardiac surgery Department of the Hospital of Emergency Medical Service (comparison group III). The sample (N=81) is represented by acute coronary syndrome (ACS) cases; 4) the cardiac surgery Department of the Clinic of Rostov State Medical University (comparison group IV). The sample (N=95) is represented by CHD patients who were on routine treatment. We calculated BMI in each comparison group. Results: in comparison group I, the BMI was 22.10±1.67 kg/m2, in group II-18.7±0.45 kg/m2, in group III – 28.01±0.58 kg/m2, in group IV – 28.66±0.47 kg/m2. The calculated value of χ2 both for all groups and for their pairwise comparison was statistically significant (p<0.01), which suggests that there is a close association of obesity with an increased risk of CHD. Conclusions: the relationship between BMI and the presence of cardiovascular pathology in I comparison group (athletes) was not established. For groups II – IV, BMI is in a statistically significant association with cardiovascular pathology.

внезапная смертьожирениекоронарный синдромишемическая болезньsudden deathobesitycoronary syndromeischemic diseaseReferencesPriori S. Task force on sudden cardiac death of the European society of cardiology // European heart journal. 2001. Vol.22, №16. P.1374-1450.Priori S. Task force on sudden cardiac death of the European society of cardiology. European heart journal. 2001;22(16):1374- 1450.Fishman GI, Chugh SS, DiMarco JP, Albert CM, Anderson ME, Bonow RO, Buxton AE, Chen PS, Estes M, Jouven X, Kwong R. Sudden cardiac death prediction and prevention: report from a national heart, lung, and blood institute and heart rhythm society workshop // Circulation. 2010.Vol.122, №22. P.2335-2348.Fishman GI, Chugh SS, DiMarco JP, Albert CM, Anderson ME, Bonow RO, Buxton AE, Chen PS, Estes M, Jouven X, Kwong R. Sudden cardiac death prediction and prevention: report from a national heart, lung, and blood institute and heart rhythm society workshop. Circulation. 2010;122(22):2335-2348.Wasfy MM, Hutter AM, Weiner RB. Sudden cardiac death in athletes // Methodist DeBakey cardiovascular journal. 2016. Vol.12, №2. P.76-80.Wasfy MM, Hutter AM, Weiner RB. Sudden cardiac death in athletes. Methodist DeBakey cardiovascular journal. 2016;12(2):76-80.Corrado D, Basso C, Schiavon M, Pelliccia A, Th iene G. Pre-participation screening of young competitive athletes for prevention of sudden cardiac death // Journal of the American college of cardiology. 2008. Vol.52, №24. P.1981-1989.Corrado D, Basso C, Schiavon M, Pelliccia A, Th iene G. Pre-participation screening of young competitive athletes for prevention of sudden cardiac death. Journal of the American college of cardiology. 2008;52(24):1981-1989.Marijon E, Bougouin W, Karam N, Beganton F, Lamhaut L, Perier MC, Benameur N, Taffl et M, Beal G, Hagege A, Le Heuzey JY. Survival from sports-related sudden cardiac arrest: In sports facilities versus outside of sports facilities //Th e American heart journal. 2015. Vol.170, №2. P.339-345.Marijon E, Bougouin W, Karam N, Beganton F, Lamhaut L, Perier MC, Benameur N, Taffl et M, Beal G, Hagege A, Le Heuzey JY. Survival from sports-related sudden cardiac arrest: In sports facilities versus outside of sports facilities. Th e American heart journal. 2015;170(2):339-345.Бокерия Л.А., Гудкова Р.Г. Сердечно-сосудистая хирургия – 2010. Болезни и врожденные аномалии системы кровообращения. М.: НЦССХ им. А.Н. Бакулева РАМН, 2011. 192с.Bokeria LA, Gudkova RG. Cardiovascular surgery – 2010. Diseases and congenital anomalies of the circulatory system. М.: Bakulev’s SCCVS RAMS, 2011. 192p. (In Russ).Бокерия Л.А., Пирцхалаишвили З.К., Сигаев И.Ю., Дарвиш Н.А., Сергуладзе Т.Н. Современные подходы к диагностике и хирургическому лечению брахиоцефальных артерий у больных ишемической болезнью сердца // Вестник РАМН. 2012. №10. С.4-11.Bokeria LA, Pirtzhalaishvili ZK, Sigaev IYu, Darvish NA., Serguladze TN. Modern approaches to the diagnosis and surgical treatment of brachiocephalic arteries in patients with coronary heart disease. 2012. Gazette RAMS; 10:4-11. (In Russ).Shaper AG, Pocock SJ, Walker M, Phillips AN, Whitehead TP, Macfarlane PW. Risk factors for ischaemic heart disease: the prospective phase of the British Regional Heart Study // Journal of Epidemiology & Community Health. 1985. Vol.39, №3. P.197-209.Shaper AG, Pocock SJ, Walker M, Phillips AN, Whitehead TP, Macfarlane PW. Risk factors for ischaemic heart disease: the prospective phase of the British Regional Heart Study. Journal of Epidemiology & Community Health. 1985;39(3):197-209.Williams PT, Hoff man KM. Optimal body weight for the prevention of coronary heart disease in normal-weight physically active men // Obesity (Silver Spring). 2009. Vol.17, №7. P.1428-1434.Williams PT, Hoff man KM. Optimal body weight for the prevention of coronary heart disease in normal-weight physically active men. Obesity (Silver Spring). 2009. 17(7):1428-1434.Moholdt T, Lavie CJ, Nauman J. Interaction of physical activity and body mass index on mortality in coronary heart disease: data from the nord-trøndelag health study // Th e American journal of medicine. 2017. Vol.130, №8. P.949-957.Moholdt T, Lavie CJ, Nauman J. Interaction of physical activity and body mass index on mortality in coronary heart disease: data from the nord-trondelag health study. Th e American journal of medicine. 2017;130(8):949-957.Finocchiaro G, Papadakis M, Dhutia H, Cole D, Behr ER, Tome M, Sharma S, Sheppard MN. Obesity and sudden cardiac death in the young: Clinical and pathological insights from a large national registry // European journal of preventive cardiology. 2018. Vol.25, №4. P.395-401.Finocchiaro G, Papadakis M, Dhutia H, Cole D, Behr ER, Tome M, Sharma S, Sheppard MN. Obesity and sudden cardiac death in the young: Clinical and pathological insights from a large national registry. European journal of preventive cardiology. 2018;25(4):395-401.Twig G, Yaniv G, Levine H, Leiba A, Goldberger N, Derazne E, Ben-Ami Shor D, Tzur D, Afek A, Shamiss A, Haklai Z. Body-Mass Index in 2.3 Million Adolescents and Cardiovascular Death in Adulthood // New England journal of medicine. 2016. Vol.374, №25. P.2430-2440.Twig G, Yaniv G, Levine H, Leiba A, Goldberger N, Derazne E, Ben-Ami Shor D, Tzur D, Afek A, Shamiss A, Haklai Z. Body-Mass Index in 2.3 Million Adolescents and Cardiovascular Death in Adulthood. New England Journal of Medicine. 2016;374(25):2430-2440.Витер В.И., Швед Е.Ф., Вавилов А.Ю. Способ оценки массы тела по размерным антропометрическим показателям в диагностике давности смерти по процессу охлаждения трупа // Проблемы экспертизы в медицине. 2005. №20-4. С.9-12.Viter VI, Shved EF, Vavilov AYu. A method for estimating body weight by dimensional anthropometric indicators in the diagnosis of prescription of death by the process of cooling a corpse. Problems of examination in medicine. 2005;20(4):9-12.(In Russ).Всемирная организация здравоохранения // Ожирение и избыточный вес. 2020. [Электронный ресурс] – Режим доступа: https://www.who.int/ru/news-room/fact-sheets/detail/obesity-and-overweightWorld Health Organization. Obesity and overweight. 2020. Available at: https://www.who.int/ru/news-room/fact-sheets/detail/obesity-and-overweight (accessed 20 April 2020)Frank K, Casabona G, Gotkin RH, Kaye KO, Lorenc PZ, Schenck TL, Lachman N, Green JB, Duran-Vega H, Cotofana S. Infl uence of Age, Sex, and Body Mass Index on the Th ickness of the Gluteal Subcutaneous Fat: Implications for Safe Buttock Augmentation Procedures // Plastic and reconstructive surgery. 2019. Vol.144, №1.P.83-92.Frank K, Casabona G, Gotkin RH, Kaye KO, Lorenc PZ, Schenck TL, Lachman N, Green JB, Duran-Vega H, Cotofana S. Infl uence of age, sex, and body mass index on the thickness of the gluteal subcutaneous fat: implications for safe buttock augmentation procedures. Plastic and reconstructive surgery. 2019;144(1):83- 92.Chen CF, Jin CL, Liu MJ, Xu YZ. Effi cacy, safety, and in-hospital outcomes of subcutaneous versus transvenous implantable defi brillator therapy: A meta-analysis and systematic review // Medicine (Baltimore). 2019. Vol.98, №19. e15490.Chen CF, Jin CL, Liu MJ, Xu YZ. Effi cacy, safety, and in-hospital outcomes of subcutaneous versus transvenous implantable defi brillator therapy: A meta-analysis and systematic review. Medicine (Baltimore). 2019;98(19):e15490.Finocchiaro G, Papadakis M, Robertus JL, Dhutia H, Steriotis AK, Tome M, Mellor G, Merghani A, Malhotra A, Behr E, Sharma S. Etiology of sudden death in sports: insights from a United Kingdom regional registry // Journal of the American college of cardiology. 2016. Vol.67, №18. P.2108-2115.Finocchiaro G, Papadakis M, Robertus JL, Dhutia H, Steriotis AK, Tome M, Mellor G, Merghani A, Malhotra A, Behr E, Sharma S. Etiology of sudden death in sports: insights from a United Kingdom regional registry. Journal of the American college of cardiology. 2016;67(18):2108-2115.Corrado D, Zorzi A. Sudden death in athletes // International journal of cardiology. 2017. №237. P.67-70.Corrado D, Zorzi A. Sudden death in athletes. International journal of cardiology. 2017;(237):67-70.Shen L, Jhund PS, Petrie MC, Claggett BL, Barlera S, Cleland JG, Dargie HJ, Granger CB, Kjekshus J, Køber L, Latini R. Declining risk of sudden death in heart failure // New England Journal of Medicine. 2017. Vol.377, №1. P.41-51.Shen L, Jhund PS, Petrie MC, Claggett BL, Barlera S, Cleland JG, Dargie HJ, Granger CB, Kjekshus J, Køber L, Latini R. Declining risk of sudden death in heart failure. New England journal of medicine. 2017;377(1):41-51.Bagnall RD, Weintraub RG, Ingles J, Dufl ou J, Yeates L, Lam L, Davis AM, Th ompson T, Connell V, Wallace J, Naylor C. A prospective study of sudden cardiac death among children and young adults // New England Journal of Medicine. 2016. Vol.374, №25. P.2441-2452.Bagnall RD, Weintraub RG, Ingles J, Dufl ou J, Yeates L, Lam L, Davis AM, Th ompson T, Connell V, Wallace J, Naylor C. A prospective study of sudden cardiac death among children and young adults. New England Journal of Medicine. 2016;374(25):2441- 52.Wong CX, Brown A, Lau DH, Chugh SS, Albert CM, Kalman JM, Sanders P. Epidemiology of sudden cardiac death: global and regional perspectives // Heart, Lung and Circulation. 2019. Vol.28, №1. P.6-14.Wong CX, Brown A, Lau DH, Chugh SS, Albert CM, Kalman JM, Sanders P. Epidemiology of sudden cardiac death: global and regional perspectives. Heart, Lung and Circulation. 2019;28(1):6-14.Kastellanos S, Aznaouridis K, Vlachopoulos C, Tsiamis E, Oikonomou E, Tousoulis D. Overview of coronary artery variants, aberrations and anomalies // World journal of cardiology. 2018. Vol.10, №10. P.127-140.Kastellanos S, Aznaouridis K, Vlachopoulos C, Tsiamis E, Oikonomou E, Tousoulis D. Overview of coronary artery variants, aberrations and anomalies. World journal of cardiology. 2018;10(10):127-140.Buxton AE. Sudden death in ischemic heart disease – 2017 // International journal of cardiology. 2017. Vol.237, P.64-66.Buxton AE. Sudden death in ischemic heart disease – 2017. International journal of cardiology. 2017;237:64-66.

The authors declare that there are no conflicts of interest present.