2013


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2013/№4

Comparative evaluation of remodeling and left ventricular systolic and diastolic volumetric hemodynamic parameters in patients with preserved and impaired ejection fraction by 4D tomoventriculography

Satlykova D.F.1, Shashkova N.V.1, Gerasimova V.V.1, Sergienko V.B.1, Mareev V.Yu.2
1 – Federal State Budgetary Institution, “Russian Cardiology Research and Production Complex” of the RF Ministry of Health Care, 3rd Cherepkovskaya 15a, Moscow 121552
2 –Federal State Budgetary Educational Institution of Higher Professional Education “M. V. Lomonosov Moscow State University”, Leninskie Gory 1, GSP-1, Moscow 119991

Keywords: diagnostics, diastolic dysfunction of the left ventricle, remodeling, CHF

DOI: 10.18087 / rhfj.2013.4.1811

Background. Radionuclide methods used for evaluation of LV systolic and diastolic function have taken special significance due to their high accuracy and reliability. Aim. Evaluating LV remodeling parameters and LV systolic and diastolic function using 4D-tomoventriculography (4D-TVG) in CHF patients with impaired or preserved systolic function (CHF-PSF). Materials and methods. The study included 69 patients with NYHA-FC II–IV CHF. Patients were divided into two groups, patients with impaired LV systolic function (CHF) (n=47) and patients with preserved LV systolic function (CHF-PSF) (n=22) based on data of two-dimensional echoCG. Control group included 10 volunteers without CHF. Evaluation of clinical condition by CSS, 6min walk test, bicycle spiroergometry, evaluation of life quality (MLWHFQ), measurement of brain natriuretic hormone (NT-proBNP) in serum, and measurement of LV dimensions and function using 4D-TVG in comparison with two-dimensional echoCG were performed for all patients. Results. The 4D-TVG method revealed substantial differences in both systolic function and LV diastolic filling rate between all CHF patients and the control group. Comparison of LV parameters in control and in CHF patients with different heart systolic function showed that the LV early diastolic filling rate was half of that in CHF patients. Also 86 % of CHF patients had the second peak of ventricular diastolic filling. The group of CHF-PSE patients did not differ from the control group by LV dimensions, LV EF values, or systolic ejection rate. Pronounced decreases in the volumetric peak ventricular filling rate (PVFR) and in the mean filling rate in the first third of diastole (DFR ⅓) along with emergence of the second diastolic filling peak were observed in 91 % of patients. The LV systolic ejection rate was significantly lower in CHF patients than in CHF-PSE patients and in subjects without CHF. Reduced rates of LV diastolic filling were observed in both groups of patients with CHF regardless of their systolic function. Conclusion. We conclude that disorders of heart diastolic filling are universal in all patients with clinically documented CHF.
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Satlykova D.F., Shashkova N.V., Gerasimova V.V. et al. Comparative evaluation of remodeling and left ventricular systolic and diastolic volumetric hemodynamic parameters in patients with preserved and impaired ejection fraction by 4D tomoventriculography. Russian Heart Failure Journal. 2013;14 (4):171-180

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