2013


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2013/№5

Comparative evaluation of remodeling parameters and right ventricular systolic and diastolic hemodynamic volumetric velocities in patients with CHF and HF-PSF by data of 4D-tomoventriculography

Saltykova D.F.1, Mareev V.Yu.2, Sergienko V.B.1
1 –Federal State Budgetary Institution, "Russian Cardiology Science and Production Center" 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: hemodynamics, right ventricle, remodeling, CHF

DOI: 10.18087 / rhfj.2013.5.1848

Background. Studying RV contractility and geometry is complicated in some respects and has certain limitations due to visualization difficulty. Aim. Evaluating and comparing remodeling parameters and RV systolic and diastolic hemodynamic volumetric velocities in patients with CHF and HF-PSF using 4D-tomoventriculography (4D-TVG). Materials and methods. The study included 69 patients with NYHA II–IV FC CHF. All patients underwent clinico-instrumental examination including evaluation of clinical signs for poor control (changes in CHF FC and CSS score), 6min walk test, bicycle spiroergometry, evaluation of the quality of life (MLWHFQ), RV dimensions and RV systolic and diastolic function using 4D-TVG, and measurement of serum NT-proBNP. The control group included 10 volunteers aged 30 to 59 years, without CHF signs. Results. Comparison of study RV parameters in patients with CHF and healthy volunteers showed only RV diastolic disorders. The greatest RV dimensions were observed in patients with systolic CHF (EDV, 160 cm). These patients also had lower EF (49 %) and LV systolic ejection velocities (–2.5 EDV / sec). Reduced RV diastolic filling velocities (DFV) were observed both throughout the entire diastole period and in the first third of diastole (rapid early diastolic filling) in all CHF patients irrespective of the LV EF value. A weak correlation was found between the LV diastolic peak filling velocity (DPFV) and RV DPFV both in patients with systolic CHF (r=0.45) and in the HF-PSF group (r=0.35). This correlation was statistically significant only for patients with CHF (р=0.003 and 0.196). A correlation was found also between RV DPFV and LV DFV⅓, which was most pronounced for patients with HF-PSF (r=0.72; р=0.003 and r=0.36; р=0.02 for patients with systolic CHF). Conclusion. The main finding was disorders of RV diastolic filling, which appeared earlier than RV dilatation and reduced contractility. These changes can be interpreted as compensatory overload of the right heart most pronounced in patients with CHF with reduced LV EF.
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Saltykova D.F., Mareev V.Yu., Sergienko V.B. Comparative evaluation of remodeling parameters and right ventricular systolic and diastolic hemodynamic volumetric velocities in patients with CHF and HF-PSF by data of 4D-tomoventriculography. Russian Heart Failure Journal. 2013;14 (5):263-271

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