Russian Heart Failure Journal 2005year Whether ejection fraction is a measure for evaluation of revascularization myocardium efficiency
Whether ejection fraction is a measure for evaluation of revascularization myocardium efficiency
Chestukhin V.V., Kolchanova S.G., Naidich A.M., Mironkov B.L., Tunyaeva I.Yu., Chestukhina O.V., Zinovjeva J.A., Sokolov S.Yu., Mironkov A.B., Kremleva J.V., Blyakhman F.A
Urgency. Revascularisation of myocardium is an effective method of surgical treatment of ischemic heart disease(IHD). Meanwhile, ambiguity of revascularization influence pays attention to parameters of intracardial hemodynamics which are traditionally used for an estimation of its efficiency. Aim. Work is devoted to finding of an opportunity of left ventricular ejection fraction application as measures of a quantitative estimation of result revascularisation of myocardium. Materials and methods. Nine patients with IHD before and after angioplastic have been surveyed by a method transezophagal echolocation. On the basis of the data of trace endocardial contour of sections of LV 3D reconstruction of the chamber of heart has been executed. The end-diastolic and the endsystolic volumes LV have been calculated on 3D reconstruction. Besides the EF has been determined by the standard methods ("Simpson", "the square-length",”Teicholz”) in the sections corresponding to standard ultrasonic heart exam. Accuracy of calculation of EF has been evaluated by calculation of a mistake of measurements between the data of 3D reconstruction and each standard method. Mechanical function of LV has been investigated in 24 regions of heart wall by calculations of regional EF on 3D reconstruction. The degree of functional (mechanical) heterogeneity of LV wall before and after angioplastic has been evaluated on regional ejection fraction variations coefficient. Results. By results of LV 3D reconstruction it is established, that revascularisation of myocardium results in significant decrease in a degree of functional heterogeneity of LV and increase of its EF. In a place with that, any of the standard methods could not fix authentic difference of EF before and after angioplastic. Research has shown, that the source of mistakes of EF calculation is covered not only in volume of the information about sizes of LV, but depends on features of regional mechanics of heart wall. And, the above, a degree of mechanical heterogeneity of a myocardium, the more mistake of EF calculation is. Conclusion. The high degree of heterogeneity of a myocardium at IHD limits using EF according to data of standart echocardiograph exam (ECG) of patients as a reliable measure of efficiency revascularization of micardium.