FACTORS ASSOCIATED WITH THE SEVERITY OF CHRONIC CEREBRAL ISCHEMIA IN PATIENTS WITH MYOCARDIAL INFARCTION COMPLICATED BY LEFT VENTRICULAR FAILURE

Abstract

We aimed to analyze the factors determining a severity degree of cerebral pathology in patients with myocardial infarction complicated with left ventricular failure and associated with chronic cerebral ischemia. Material and methods. The study included 182 patients with Q-wave myocardial infarction and concomitant chronic cerebral ischemia (CCI), complicated with left ventricular failure, 149 (81.9 %) men and 33 (18.1 %) women. The mean age was 60.5 (53.0; 69.0) years. The following procedures were performed: clinical and anamnestic examination, selective coronary angiography, echocardiography and duplex scanning of the arteries. Results. The signs of CCI grade II were revealed in 67.6 % of the patients, CCI grade I – in 20.9 % of the patients, 11.5 % of the patients had cerebrovascular accident and transient ischemic attack. All the patients had intima-media thickness more than 0.1 cm. No patients with hemodynamically significant stenoses of extracranial arteries were revealed; in 37.4 % of the patients less than 50 % carotid stenoses were detected. The patients with multivessel coronary bed lesions prevailed. The severity of CCI was associated with the multifocality of the atherosclerosis, history of arterial hypertension, hypercholesterolemia, angina pectoris, previous MI and chronic heart failure. Conclusion. The factors which determine the severity of the clinical course of CCI in this group are not the presence of hemodynamically significant extracranial stenoses, but the previous coronary history and multifocality of the atherosclerotic process.