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Dynamics of indices of diastolic function of the right ventricle in patients with acute coronary syndrome following transcatheter coronarography intervention

Sumin A. N., Galimzianov D. M., Sergeeva T. Yu., Barbarash O. L.

Keywords: diagnostics, diastolic dysfunction of the right ventricle, acute coronary syndrome, transcatheter coronary intervention

DOI: 10.18087/rhfj.2012.6.1758

Relevance. In patients with acute heart failure, RV function was studied mainly at RV MI, and adverse prognostic significance of the function decrease was demonstrated. However at presence of left ventricular HF and in patients with stable CHD, indices of RV function have independent prognostic significance, which makes it relevant to study them at any MI localization. Objective. Study dynamics of various indices of RV diastolic function in patients with ACS following transcatheter coronary intervention (TCI). Materials and methods. 73 patients with acute ST segment elevated MI following primary TCI with stent angioplasty of the infarct-related artery were enrolled to the study. Echocardiography was carried out on day 1 (in 20–24 hours after onset of the disease) and days 5 and 12 of the disease. Besides LV and RV structural indices, RV diastolic function indices were estimated. In the tissue Doppler echocardiography mode, peak velocities of mitral annulus (Et) in the phase of early filling and the phase of atrial systole (At) were measured. Early RV filling velocity (EFV). Results. In MI patients at serial estimation of EchoCG during hospitalization, improvement of FV RV (with 64±9.6 to 70.4±19.2 %; р=0.00001) was noted. Indices of RV diastolic function had different dynamics: Et / At ratio did not change (0.69±0.25 and 0.71±0.28; р=0,391), while EFV decreased (38.0±8.5 to 36.2±7.7 cm / s; р=0.0243). Conclusion. In MI patients in the first days after TCI, significant decrease of RV systolic function and velocities of mitral annulus is noted; by day 12, these indices, reflecting mainly function of RV longitudinal muscles, improve. On the contrary, RV filling velocity is normal in the first days and decreases by day 12, which testifies deterioration of RV suction capacity. Further studies must be carried out to specify mechanisms responsible for differently directed dynamics of RV diastolic function indices in patients following TCI concerning acute MI.
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Sumin A. N., Galimzianov D. M., Sergeeva T. Yu. et al. Dynamics of indices of diastolic function of the right ventricle in patients with acute coronary syndrome following transcatheter coronarography intervention. Russian Heart Failure Journal. 2012;13(6):334-341

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