Russian Heart Failure Journal 2009year Role of myocardial electric remodeling in progression of CHF in elderly and senile men with IHD


To access this material please log in or register

Register Authorize
2009/

Role of myocardial electric remodeling in progression of CHF in elderly and senile men with IHD

Tantsyreva I.V., Volkova E. G.

Keywords:

DOI:

Urgency. Structure and spatial myocardial rearrangement in patients with IHD complicated by CHF is interrelated with changes in parameters of velocity determinants in heart electric activity and myocardial electric remodeling. Aim. To study phases of myocardial electric remodeling in different CHF FC. Materials and methods. 167 elderly and senile men with IHD complicated with CHF (mean age, 75.4 years) were evaluated. 113 healthy men aged 18–65 years made up a control group. The structure and function myocardial remodeling was evaluated using data of two-dimensional echocardioscopy; parameters of repolarization heterogeneicity and rate of ventricular activation (RVA) were studied according to the method of E.G. Volkova (1990). A Kaplan-Meyer survival analysis was performed for a 10-year period in relation to RVA values. Results. According to the data obtained, RVA was significantly lower in patients with IHD than in healthy men of the control group. With advanced age, RVA parameters tended to decrease. A progressive decline of RVA values was observed with higher CHF FC. With higher IHD FC in the structure of RVA values, the proportion of phase III myocardial electrical remodeling increased. Left ventricular myocardium weight index (LVMWI) increased with progression of CHF. Correlation was found between RVA and CHF FC, LV myocardium weight, LV cavity dimensions, EF, myocardial stress (MS), and eccentric myocardial remodeling. Processes of cardiomyocyte electric death were associated with increased dimensions of the LV cavity, myocardial weight, increased MS, eccentric myocardial remodeling and more prolonged and heterogenic repolarization intervals. The structure and function rearrangement and maladaptive myocardial remodeling in CHF were accompanied by a progressive decline of RVA and a significant increase in frequency of phase III myocardial electric remodeling in the structure of rate parameters of the heart electric activity.
  1. Беленков Ю. Н., Мареев В. Ю., Агеев Ф. Т. Эпидемиологические исследования сердечной недостаточности: состояние вопроса. Журнал Сердечная Недостаточность. 2002; 3 (2):57–58.
  2. Оганов Р. Г., Масленникова Г. Я. Вклад сердечно-сосудистых и других неинфекционных заболеваний в здоровье населения России. Сердце. 2003; 2 (2):58–61.
  3. Фомин И. В., Мареев В. Ю., Щербина Е. В. Показатели распространенности сердечной недостаточности и эффективности ее терапии в зависимости от тяжести заболевания. Журнал Сердечная Недостаточность. 2002; 3 (2):69–70.
  4. Беленков Ю. Н. Хроническая сердечная недостаточность в России – опыт 25 лет: где мы находимся и куда должны идти? Журнал сердечная недостаточность. 2003; 4 (1):9–11.
  5. Агеев Ф. Т., Даниелян М. О., Мареев В. Ю., Беленков Ю. Н. Больные с хронической сердечной недостаточностью в российской амбулаторной практике: особенности контингента, диагностики и лечения (по материалам исследования ЭПОХА-О-ХСН). Журнал Сердечная Недостаточность. 2004; 5 (1):4–7.
  6. Мареев В. Ю. Блокада процессов ремоделирования сердца: реальность или недостижимый идеал? Журнал Сердечная Недостаточность. 2003; 4 (1):46–47.
  7. Фомин И. В., Беленков Ю. Н., Мареев В. Ю. и др. Распространенность ХСН в Европейской части Российской Федерации – данные ЭПОХА-ХСН. Журнал Сердечная Недостаточность. 2006; 7 (1):4–7.
  8. Волкова Э. Г. Электрическое ремоделирование миокарда – общая закономерность взаимосвязи и сохранения энергии сердца. Новые технологии профилактики, диагностики и лечения в клинике внутренних болезней: Материалы научно-практической конференции кафедры терапии, функциональной диагностики и профилактической медицины УГМАДО. Челябинск. 1998; 3:10–12.
  9. Волкова Э. Г. Ранняя диагностика и прогнозирование ишемической болезни сердца. Челябинск. 2003:32.
  10. Дмитриев В. Л., Волкова Э. Г., Левашов С. Ю. Роль суммарного поражения коронарного русла в ремоделировании сердца у больных стенокардией, сочетающейся и не сочетающейся с артериальной гипертензией. Терапевтический архив. 2002; 74 (4):53–55.
  11. Leotta G, Maule S, Rabbia F et al. Relationship between QT interval and cardiovascular risk factors in healthy young subjects. J Hum Hypertens. 2005; 19 (8):623‑627.
  12. Furman NV, Dovgalevskii PIa, Morozov IA. Dynamics of corrected QT interval and heart rate in patients with early postinfarction angina. Klin Med (Mosk). 2005; 83 (2):22–24.
  13. Sheehan J, Perry IJ, Reilly M et al. QT dispersion, QT maximum and risk of cardiac death in the Caerphilly Heart Study. Eur J Cardiovasc Prev Rehabil. 2004; 11 (1):63–68.
  14. Sredniawa B, Musialik-Lydka A, Pasyk S. Dispersion of the QT interval in unstable angina pectoris. Pol Arch Med Wewn. 2000; 103 (1–2):41–45.
  15. Musha H, Kunishima T, Awaya T, Iwasaki T et al. Influence of exercise on QT dispersion in ischemic heart disease. Jpn Heart J. 1997; 38 (2):219‑226.
  16. Lee KW, Kligfield P, Dower GE et al. QT dispersion, T-wave projection, and heterogeneity of repolarization in patients with coronary artery disease. Am J Cardiol. 2001; 87 (2):148‑151.
  17. Doven O, Ozdol C, Sayin T et al. QT interval dispersion: non-invasive marker of ischemic injury in patients with unstable angina pectoris? Jpn Heart J. 2000; 41 (5):597‑603.
  18. Demir AD, Senen K, Balbay Y et al. Effects of atrial pacing on QT dispersion in patients with coronary artery disease without angina pectoris and ST segment depression. Angiology. 2001; 52 (6):393‑398.
  19. Yilmaz R, Demirbag R, Gur M. The association of QT dispersion and QT dispersion ratio with extent and severity of coronary artery disease. Ann Noninvasive Electrocardiol. 2006; 11 (1):43–51.
  20. Ozdemir K, Altunkeser BB, Aydin M et al. New parameters in the interpretation of exercise testing in women: QTc dispersion and QT dispersion ratio difference. Clin Cardiol. 2002; 25 (4):187‑192.
  21. Puljevic D, Smalcelj A, Durakovic Z et al. Effects of postmyocardial infarction scar size, cardiac function, and severity of coronary artery disease on QT interval dispersion as a risk factor for complex ventricular arrhythmia. Pacing Clin Electrophysiol. 1998; 21 (8):1508–1516.
  22. Harjai KJ, Samal A, Shah M et al. The relationship between left ventricular shape and QT interval dispersion. Echocardiography. 2002; 19 (8):641‑644.

To access this material please log in or register

Register Authorize
Ru En