The peripheral circulation in patients with acute coronary syndrome

Abstract

Purpose. The aim of this study was to evaluate the microcirculation in patients with acute coronary syndrome over the course of the disease. Design/methodology/approach. 48 patients were examined with average age of 65.3±5.1 years. The patients were delivered in an intensive care unit with a diagnosis of acute coronary syndrome. Analysis of clinical, instrumental and laboratory parameters was made depending on the final diagnosis: «myocardial infarction» - 26 patients, «unstable angina» - 22 patients. In addition, both linear and volume blood flow were evaluated on the distal phalanx of second finger of the right hand in all patients using the method of high-frequency (25 MHz) ultrasound Doppler study. Findings. At admission, in patients with acute myocardial infarction the linear velocity of blood flow was 10.27±1.18 mm/s, the volume rate of flow 4.67±0.55 ml/min; in the subgroup of patients with unstable angina these figures were 14.09±1.50 mm/s and 6.64±0.71 ml/min, respectively (p<0.05). After 12-24 hours on a background of the therapy in patients with myocardial infarction an increase of the studied parameters is registered (12.3±1.7 mm/s and 6.33±0.96 ml/min for linear and volumetric blood flow velocity). The inverse correlations between the indices of the peripheral circulation and the size of the left and right atria, and end-diastolic size of left ventricular were identified. Originality/value. Patients with acute myocardial infarction in the start of disease showed significantly lower rates of microcirculation with their subsequent growth, in comparison with the patients with unstable angina, where the opposite dynamic is registered at the initially higher values of the microcirculation. The statistical correlation analysis was made. In patients with acute coronary syndrome it defined a reverse reliable link of microcirculation parameters with the end-diastolic size of the left ventricle, the size of the left and right atrium, as well as the level of sodium in blood plasma.