Features of left ventricular myocardial remodeling associated with state of coronary сollateral arteries in patients with intermediate function of left ventricle and background of acute decompensation of heart failure

Abstract

Features of left ventricular myocardial remodelling depending on the state of collateral coronary flow are presented. Disorders of the left ventricle`s myocardium local contractility in patients with the intermediate function of left ventricle under acute decompensation of heart failure were studied. It was established that in such patients with postinfarction cardiosclerosis the main disorders were more often obtained in the basal and middle parts of lower and posterior walls of left ventricle vascularized by a circumflex branch of the left coronary artery or right coronary artery. It was shown that as blood flow increased in coronary collaterals; increase in left ventricular ejection fraction was 7%. In this case, an improvement in collateral blood flow by 1 point according to the Rentrop’s modified classification was accompanied by an increase in the left ventricular ejection fraction by 2 relative percents. In addition, in patients with intermediate left ventricular function, types of left ventricular myocardial remodelling were determined. Thus, in the pathogenesis of acute decompensation of heart failure, an important link is remodelling of the left ventricular myocardium, that is a complex of changes in structure and geometry that occurred under the action of trigger factor. Determination of qualitative type of remodelling, as well as its relationship with changes in extracellular matrix, is important for assessing the risk of cardiovascular complications and selecting adequate therapeutic tactics. and a volume fraction of interstitial collagen was calculated in patients with intermediate left ventricular function and background of acute decompensation of heart failure.