2012


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2012/№4

Factors associated with dilatation of the left ventricle in CHD patients

Yaroslavskaya E. I., Kuznetsov V. A., Pushkarev G. S.

Keywords: left ventricle dilatation, coronary heart disease

DOI: 10.18087/rhfj.2012.4.1652

Relevance. Ishemic cardiomyopathy is traditionally linked with remodelling of myocardial tissue after myocardial infarction in the network of whitch dylatation syndrome is marked out. In this paper, we tried to find out what can promote the dilatation of LV in CHD patients without past MI. Objective. Reveal the factors associated with LV dilatation in CHD patients without past MI. Materials and methods. 2 443 patients with CHD (at presence of hemodynamically significant coronary stenoses according to coronary angiography – more than 50 % artery lumen) without acute or anamnestic MI was sel ected fr om the “Register of the performed coronary angiography surgeries”©. The study also excluded persons with heart diseases. The patients were divided into the following groups: 50 patients with moderate or apparent LV dilatation (LV end diastolic diameter 60 mm and more) and 1992 patients without LV dilatation (LV end diastolic diameter 55 mm and less). Results. The comparison of clinical functional parameters of the groups showed that patients with LV dilatation had DM (22.2 % vs. 10.8 %, р=0.008) more often, higher HF FC (III) after NYHA (34.1 % vs. 9.7 %, р<0.001) and heart rhythm disturbances (70.6 % vs. 22.0 %, р<0.001), myocardial mass index (129.4±28.6 vs. 184.4±34.8 g / m², р<0,001) was higher and LVEF (41.9±10.3 vs. 60.7±4.9 %, р=0.001) was lower. However, they had more seldom severe (III–IV) exertional angina FC (39.5 % vs. 55.8 %, р=0.033), multiple coronary stenoses (3 and more vessels) (24.5 % vs. 37.7 %, р=0.05) and lesions of a diagonal branch (2.2 % vs. 15.7 %, р=0.041) less often. Multivariant analysis showed independent connection of left ventricular dilatation with heart rhythm disturbances, smaller quantity of the affected coronary arteries, decreased LVEF, increased myocardial mass index. Conclusion. Factors associated with LV dilatation in CHD patients without past MI are heart rhythm disturbances, smaller quantity of the affected coronary arteries, decreased LVEF, myocardial mass index. Nonischemic component may be present in the mechanism of LV dilatation in such patients.
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Yaroslavskaya E. I., Kuznetsov V. A., Pushkarev G. S. Factors associated with dilatation of the left ventricle in CHD patients. Russian Heart Failure Journal. 2012;13(4):195-199

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