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Effect of myocardial revascularization on early diastolic flow propagation velocity in the left ventricle in patients with myocardial infarction

Sumin A. N., Galimzianov D. М., Sergeeva T. Yu., Barbarash O. L.
Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases” at the Siberian Branch of the Russian Academy of Medical Sciences, Sosnovy Bulvar 6, Kemerovo 650002

Keywords: myocardial infarction, myocardial revascularization, surgical methods, echocardiography

DOI: 10.18087/rhj.2013.1.1640

Relevance. Presence of LV diastolic dysfunction in MI patients influences clinical status and forecast of patients. Traditional indicators of diastolic function are still widely used in clinical practice and scientific studies. There is data about additional significance of diastolic dysfunction evaluation by means of LV filling early diastolic flow at color Doppler M-mode in comparison with other markers. Objective. Study possibility of using indicators of early diastolic flow propagation in dynamic evaluation of diastolic filling in MI patients after revascularization. Materials and methods. The study involved 169 patients with acute MI with ST segment elevation (119 male and 50 female, 60.8±18 years old). All subjects were divided into 3 groups: group without reperfusion (n=55), group of thrombolytic therapy (TLT, n=53), group of transcutaneous coronary intervention (TCI, n=61). Reperfusion in both groups was performed within the first 6 hours after onset of the disease. EchoCG was carried out on the 1st, 5th and 12th days of the disease with evaluation of traditional indicators of LV diastolic function (Е, A, Е / A, DTE, IVRT) and flow propagation velocity (Vp) of early diastolic filling and Е / Vp ratio. Results. Traditional indicators of LV diastolic function based on the analysis of transmitral blood flow did not allow definitely evaluate dynamics of diastolic filling in patients with acute MI during hospitalization. Vp reduction was noted by the 12th day of the disease in group with no myocardial reperfusion (41.1±10.2 to 37.8±7.5 cm / s; р<0.05) and TLT (40.5±12.7 to 35.7±9.1 cv / s; р=0.028). In TCI group, this indicator didn’t got worse during treatment (39.9±12.4 and 40.9±7.6 cv / s; р=0,94). Е / Vp ratio, noninvasive marker of level intraventricular pressure, increased in no-reperfusion and TLT groups and did not change during treatment in TCI group. Conclusion. The indicators based on studying of LV filling flow propagation are advisable to be used in complex evaluation LV diastolic dysfunctions in MI patients.
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Sumin A. N., Galimzianov D. М., Sergeeva T. Yu. et al. Effect of myocardial revascularization on early diastolic flow propagation velocity in the left ventricle in patients with myocardial infarction. Russian Heart Journal. 2013;12(1):21-27

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