Abstract
Aim of the study was to identify the effects of myocardial revascularization on the prognosis in patients with altered coronary blood flow detected by transthoracic ultrasound.Material and Methods. Four hundred and twelve (412) patients were included in the study. The inclusion criterion was coronary velocity more than 70 cm/s during echocardiography. The study population was divided into three groups: Group 1 comprised patients with high velocities in the coronary arteries detected by ultrasound, in whom myocardial revascularization was performed; Group 2 comprised patients with high velocities in the coronary arteries, in whom myocardial revascularization was not performed and; the Control Group comprised patients with normal coronary blood flow according to ultrasound. The follow-up period was 10–11 months.Results. Seventeen (17) deaths (4.7%) occurred during follow-up. Death rates were 1.6 vs. 8.1 vs. 0% in Group 1, Group 2 and the Control Group, respectively, with a p-value for the difference between Group 1 and Group 2 (p1) of <0.009; and a p-value for the differences compared with the Control group (р2) of <0.03. Death, myocardial infarction, pulmonary edema, and acute coronary syndrome were observed in 27 patients (7.7% of the study group with accelerated blood flow). The rates of these outcomes were 4.9 vs. 11.0 vs. 0% in Group 1, Group 2, and the Control Group, respectively (p1<0.05; p2<0.006). Discussion. The study showed high rates of mortality or acute coronary events in the group of patients with pathologically high coronary flow velocities. The positive effects of revascularization on survival in this group were verified.Conclusions: 1. Left artery coronary flow velocities over 70 cm/s indicate a high probability of death or acute coronary events within 10.5 months.2. Myocardial revascularization has a significant positive effect on the survival rate and incidence of acute coronary events in patients with coronary artery flow velocities greater than 70 cm/s.3. Patients with high coronary blood flow velocities should be referred to coronary angiography or other diagnostic tests without waiting for clinical manifestations and specific symptoms for coronary artery disease.
Highlights
Цель: определить влияние реваскуляризации миокарда на прогноз пациентов с измененным коронарным кровотоком по данным трансторакального ультразвукового исследования
Aim of the study was to identify the effects of myocardial revascularization on the prognosis in patients with altered coronary blood flow detected by transthoracic ultrasound
The study population was divided into three groups: Group 1 comprised patients with high velocities in the coronary arteries detected by ultrasound, in whom myocardial revascularization was performed; Group 2 comprised patients with high velocities in the coronary arteries, in whom myocardial revascularization was not performed and; the Control Group comprised patients with normal coronary blood flow according to ultrasound
Summary
Kamenskikh M.S., Zagatina A.V., Zhuravskaya N.T., Fedotov Y.N., Shmatov D.V. The Role of Myocardial Revascularization in the Survival of Patients with Altered Coronary Blood Flow Detected by Transthoracic Ultrasound. В проведенном исследовании была показана высокая смертность/частота острых коронарных событий в группе пациентов с патологически высокими скоростями коронарного кровотока, визуализированного при помощи трансторакального ультразвукового исследования. Однако в указанной работе не проводился анализ влияния реваскуляризации миокарда на последующие неблагоприятные события у групп пациентов с высокими скоростями коронарного кровотока, визуализированными при помощи трансторакального ультразвукового исследования. В настоящем исследовании группы с реваскуляризацией и без реваскуляризации миокарда не были рандомизированы, не было получено статистически значимых различий при сравнении базовых характеристик этих групп по таким параметрам, как возраст, индекс массы тела, гипертония, фракция выброса левого желудочка, а также по показателям максимальных скоростей кровотока в коронарных артериях. Recommendations for chamber quantification: a report from the American Society of Echocardiogra-
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