Abstract
The aim: To study the influence of chronic heart failure of different origin on the energetics of blood circulation in case of polytrauma without myocardial damage. Materials and methods: 32 patients with polytrauma without myocardial injury were examined that was assessed by the level of Troponin I not exceeding 0.3 ng/ml. The patients were divided into two groups: 1st group (n=15) without chronic heart failure (CHF), and the 2nd one - with CHF. The absence of CHF was proved by the level of NT-proBNP not exceeding 90 pg/ml. Circulatory reserve (CR) was an integral energy index. All measurements were made at the patients' admittance to the hospital, on the 3rd and the 7th day after admittance. Results: During admittance, CR in the groups was low without a significant difference (in the 1st group - 117±44, in the 2nd group - 99±39 mW/m2, p = 0.2). CR was increasing in the 1st group quicker than in the 2nd one; on the seventh day it reached 414±128 mW/m2 growing out of dangerous values, while the 2nd group showed only up to 295±96 mW/m2 (p = 0.005), which is lower than reference values. Conclusions: A severer disorder occurs in patients with initial CHF. The treatment requires the improvement of myocardium metabolism. An important prognosis criterium of severity can be represented by the level of circulatory reserve; its value below 100-120 mW/m2 is a worse outcome predictor.
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