Holter Monitoring (24-Hour ECG) Parameter Dynamics in Patients with Ischemic Heart Disease and Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia

Dmitrii N Fiev, Andrey Z Vinarov, Dmitrii G Tsarichenko, Phillip Yu Kopylov, Yuri L Demidko, Abram L Syrkin, Leonid M Rapoport, Yuri G Alyaev, Pyotr V Glybochko, Dmitrii N Fiev, Andrey Z Vinarov, Dmitrii G Tsarichenko, Phillip Yu Kopylov, Yuri L Demidko, Abram L Syrkin, Leonid M Rapoport, Yuri G Alyaev, Pyotr V Glybochko

Abstract

Introduction: This study examined the dynamics of 24-h electrocardiogram (ECG) monitoring parameters (Holter monitoring) in patients with ischemic heart disease (IHD) before and after conservative or surgical treatment of patients with voiding and storage lower urinary tract symptoms (LTS) due to benign prostatic hyperplasia (BPH).

Methods: A total of eighty-three 57 to 81-year-old (mean age 70.4 ± 5.75 years) patients with LUTS/BPH and accompanying IHD were examined and treated at the Institute of Urology and Human Reproductive Health and Clinic of Cardiology of Sechenov University. All patients received recommended cardiac therapy at least 6 months before inclusion in the study.

Results: Our study demonstrated that there is correlation between voiding and storage LUTS/BPH and Holter-detected cardiac impairments in patients with IHD/BPH. These data make it possible to consider LUTS/BPH (voiding and storage) as a factor in the additional functional and psychological load on the activity of patients with ischemic heart disease. Improvement of voiding and storage LUTS due to BPH and objective parameters of urination (Qmax) in patients treated with alpha-1 adrenoceptor blocker tamsulosin correlated with improvement of 24-h ECG monitoring parameters (Holter monitoring) in 72% of patients. Improvement of 24-h ECG monitoring parameters (Holter monitoring) 1 month after transurethral resection of the prostate (TURP) in IHD/BPH patients and indications for surgical treatment was observed in 65.7%. Negative dynamics of the Holter-based ECG was not registered in patients who were operated on.

Conclusion: Holter monitoring helps to identify groups of patients in whom urinary impairments caused by prostatic hyperplasia negatively affect the course of IHD. Restored urination (either conservatively or operatively) in patients with BPH in 72% of cases decreased the number of fits of angina, thus influencing favourably the course of IHD.

Trial registration: ClinicalTrials.gov Identifier: NCT03856242.

Keywords: Alpha-1-adrenoblockers; Benign prostatic hyperplasia (BPH); Cardiac rhythm; Holter monitoring (HM); Ischemic heart disease (IHD); Lower urinary tract symptoms (LUTS); Transurethral resection of the prostate (TURP); Voiding dysfunctions.

Figures

Fig. 1
Fig. 1
Mean value of subjective and objective parameters of urination before and after therapy with tamsulosin 0.4 mg in patients of the first group: a IPSS; b QoL; c Q max; d Q mean; e RU
Fig. 2
Fig. 2
Dynamics of the scores of the Seattle Angina Questionnaire in patients of the first group
Fig. 3
Fig. 3
Mean value of subjective and objective parameters of urination before and after therapy with tamsulosin 0.4 mg in patients of the second group: a IPSS; b QoL; c Q max; d Q mean; e RU
Fig. 4
Fig. 4
Dynamics of the scores of the Seattle Angina Questionnaire in patients of the second group
Fig. 5
Fig. 5
Mean value of subjective and objective parameters of urination before and after surgery (TURP) in patients of the third group: a IPSS; b QoL; c Q max; d Q mean; e RU

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