Оценка жизнеспособности миокарда после реваскуляризации у больных с ишемичекой болезнью сердца

Abstract

Some aspects of the definition of medical tactics relating to the definition of myocardial viability before revascularization in patients with coronary heart disease are considered in detail in the article. Methods. A total of 65 patients with CHD, including 20 patients with type 2 diabetes are examined. The presence and severity of coronary artery lesion was performed by coronary angiography. Subsequent percutaneous coronary intervention (PCI) was performed in 32 patients. Strain echocardiography is made for all patients before PCI and one year after PCI. Result. According to coronary angiography in patients with CHD and type 2 diabetes in 25 % of case registered atherosclerotic lesions of a coronary artery and a 45 % loss of two or three coronary arteries, compared with 40 % and 20 %, respectively, in patients with CHD without type 2 diabetes (p˂0.05). Number of abnormal segments, restore function one year after PCI in the first group was significantly lower than in the second group (27 % vs 35 %). Assessment of left ventricular myocardial contractile function 1 year after revascularization showed that the recovery of the longitudinal (LongS, %), radial (RadS, %) and circular (CircS, %) strain in patients of group 1 is expressed to a much lesser extent. Conclusions. In patients with decreased global LV contractility requires assessment of myocardial viability is necessary before myocardial revascularization to confirm its feasibility. The presence of type 2 diabetes slows recovery of viable myocardium after revascularization compared with patients without diabetes. Carrying the strain echocardiography before and after myocardial revascularization is justified to assess the recovery of myocardial contractility