Disorders of the autonomic nervous system are involved in the pathogenesis of all diseases, but their investigation is of the utmost importance in cardiology. Modulation of the autonomic nervous system is now considered as a strategy of therapeutic influence on cardiovascular diseases. Purpose was to review the current views on the mechanisms, clinical manifestations, diagnosis and treatment of autonomic cardioneuropathy, in particular, of biliary origin, and to pool own data on this topic. Literature review in the Pubmed database and summary of the results of own research. The innervation axis of the heart is a multilevel system of integrative centers, which determines the complexity of the interaction mechanisms. Viscero-visceral reflexes are the main trigger of changes in the autonomic nervous system activity. Biliary-cardiac interactions cause the development of biliary autonomic viscero-visceral cardioneuropathy (BAVVCNP). In such cases, cholecystectomy improves the condition of the heart, but metabolic disorders and neuroendocrine imbalance persist, which leads to the clinical symptoms of postbiliary cardioneuropathy (PBCNP). According to our own research, BAVVKCP is accompanied by a significant increase in heart rate, left ventricular dilatation, systolic dysfunction. On the background of PBCNP structural and functional parameters of the heart improve, and arrhythmogenic activity of the myocardium reduces. Autonomic cardioneuropathy is a consequence of viscero-visceral reflexes and disorders of myocardial metabolism at the cellular level. Cardioneuropathy leads to various clinical manifestations with electrical instability, arrhythmias, ventricular dysfunction and remodulation, and coronary insufficiency. Manifestations of biliary autonomic viscero-visceral cardiopathy include the increased heart rate and arrhythmia, prolongation of ventricular systole and depression of the ST interval, and arterial hypertension. 4. In patients with postbiliary cardioneuropathy, the structural and functional parameters of the heart improve and the number of arrhythmias decreases, which indicates the interruption of pathological autonomic impulses.
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