2014


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2014/№1

Evaluation of pulmonary ventilation and diffusion capacity parameters in patients with myocardial infarction

Katsyuba M. V., Karetnikova V. N., Polikutina O. M., Slepynina Yu. S., Barbarash O. L.

Keywords: pulmonary ventilation and diffusion capacity, myocardial infarction, instable angina, CHF

DOI: 10.18087/rhj.2014.1.1774

Background. Disorders of pulmonary diffusion capacity along with myocardial dysfunction may contribute to development of heart failure (HF) in patients with myocardial infarction (MI). Aim. To evaluate clinical significance of pulmonary ventilation and diffusion capacity in patients with MI. Materials and methods. 37 patients with MI including 26 (70%) patients with Q-wave MI were enrolled in the study. The reference group consisted of patients with stable angina without MI and bronchopulmonary disease. Data of  EchoCG, spirography, body pletismography, and pulmonary diffusion capacity were evaluated at 10 days of MI. Pulmonary function was studied using the computerized diagnostic system Medgraphics ELITE DL (Medical Graphics Corporation, USA). Results. Values of pulmonary capacity parameters were significantly decreased whereas values of expiratory reserve volume, intrathoracic volume, and the residual volume to total pulmonary capacity ratio were increased compared to the group of patients with stable angina. In MI patients, indices of pulmonary diffusion capacity (DLCO and DL/VA) were significantly lower (10% and 7%, respectively) than in patients with stable angina, which suggested much more severe injury of the alveolar-capillary membrane (ACM) in MI. Comparison of pulmonary ventilation and diffusion capacity in patients with Q-wave and non-Q wave MI demonstrated significantly lower values of hemoglobin-adjusted (70% and 84% of normal, respectively, р=0.035) and non-hemoglobin adjusted pulmonary diffusion capacity (68% and 85.5%, р=0.043) in patients with Q-wave MI. Conclusion. Significantly reduced pulmonary diffusion capacity is characteristic of Q-wave MI. These changes are probably caused by both impaired myocardial function and ACM injury by a number of factors activated in ACS.
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Katsyuba M. V., Karetnikova V. N., Polikutina O. M. et al. Evaluation of pulmonary ventilation and diffusion capacity parameters in patients with myocardial infarction. Russian Heart Journal. 2014;75 (1):26–31

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