Energy of blood circulation in primary reduction of myocardial contractility

Abstract

The aim: to study the energy parameters of the circulatory system in heart failure in patients with acute coronary syndrome (ACS) against the background of coronary artery bypass grafting (CABG), depending on the degree of myocardial contractility decrease.Materials and methods. In 48 patients with ACS in the perioperative period energy parameters of blood circulation have been determined: flow power (FP), oxygen reserve (OR) and circulatory reserve (CR). FP reflects the useful power of the myocardium, OR – the correspondence of oxygen absorption by tissues to their needs, CR is an integral energy parameter. Patients have been divided into 2 groups: group CF1 (n = 18) – patients with an ejection fraction (EF) of less than 40 %, group CF2 (n = 30) – patients with EF of at least 40 %. The same treatment has been performed in both groups.Results. The initial energy parameters of circulation were significantly reduced, more so in the CF1 group. During treatment, FP, OR, and CR in the CF1 group increased more slowly than in the CF2 group, and remained significantly lower by the end of the study. The initial CR was highly correlated with the need for dobutamine, the duration of postoperative artificial blood circulation, and postoperative mechanical ventilation, so CR can also be used as a predictive criterion.Conclusions. Determination of energy indicators of blood circulation allows you to fully assess the state of the circulatory system, predict the course of its insufficiency and monitor the effectiveness of its treatment. The severe decrease in myocardial contractility, accompanied by a decrease in the EF to 40 % or lower, slows down the recovery of energy parameters of circulation and requires the search for more effective methods of intensive therapy