Сравнительная характеристика больных с ишемической болезнью сердца и стенозирующим атеросклерозом коронарных артерий в зависимости от показателей моментального резерва кровотока

Abstract

The paper presents a comparative analysis of 56 patients suffering from stable ischemic heart disease and coronary artery stenosis in the range of 65–90% depending on the instantaneous wave-free ratio (iFR). Two groups of 28 patients took part in the research. The index iFR was less than 0,80 in the first group, whereas it was more than 0,94 in the second. It reveals that the indexes of the pre-test probability of coronary artery disease (CAD) did not significantly differ among the groups of patients irrespective of the different iFR values. Patients with low iFR indexes (the first group) tend to have diabetes mellitus as the result of overweight, predominant systolic hypertension, diastolic myocardial dysfunction, atherogenic dyslipidemia, and visible signs of renal dysfunction. According to the exercise ECG Stress test results, the patients of the first group were more frequently diagnosed with symptoms of the myocardial ischemia and its electrical instability in the form of high gradations of ventricular extrasystole. The paper outlines that the previously described factors increase the probability of low iFR with the same initial pre-test probability of CAD, so they can be used as indicators of the advisability of performing endovascular interventions in patients with chronic coronary syndrome.