2014


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2014/№3

Values of segmental longitudinal myocardial deformation at rest before and after coronary bypass surgery in patients with postinfarction cardiosclerosis

Gilyarov M.Yu., Murashova N.K., Novikova N.A., Sedov V.P., Syrkin A.L.
State Budgetary Educational Institution “I. M. Sechenov First Moscow State Medical University” of the RF Ministry of Health Care, Trubetskaya 8, Bld. 2, Moscow 119991

Keywords: coronary artery bypass, myocardium deformations, treatment, postinfarction cardiosclerosis, surgical methods

DOI: 10.18087/rhj.2014.3.1911

Background. A promising method for detecting hibernating myocardium is evaluation of myocardial deformation at rest. Aim. To compare values of segmental longitudinal myocardial deformation at rest calculated with speckle-tracking EchoCG before and after coronary bypass surgery in patients with postinfarction cardiosclerosis. Materials and methods. 42 patients with postinfarction cardiosclerosis and impaired local contractility were evaluated. The patients were men aged 41 to 73 years (median age, 57 years) who were hospitalized for coronary bypass surgery. Standard EchoCG with evaluation of areas with impaired local contractility and speckle-tracking EchoCG for determination of myocardial longitudinal deformation values were performed in all patients before and 6 months after revascularization. Postoperative myocardial longitudinal deformation values were evaluated in relation to baseline values. Results. In total, 510 myocardial segments were analyzed. Originally, 333 segments were normokinetic; 102 segments were hypokinetic; and 72 segments were akinetic. Longitudinal deformation values were 15.7±5.5 for normokinesis; 9.3±4.6 for hypokinesis; and 5.3±4.5 for akinesis (p<0.0001). According to data of speckle-tracking EchoCG, the mean longitudinal deformation value was 11.7±6.8 before the surgery and 14.7±6.1 after the surgery (p<0.0001). Deformation values before and after revascularization were significantly correlated (r=0.665; p<0.01). At values corresponding to normokinesis and akinesis, only slight changes in deformation values (0.8 and –3.2, respectively, p<0.001) were observed after revascularization. The greatest improvement of deformation values (–4.7, p<0.0001) was observed in segments with originally hypokinetic values of longitudinal deformation. Maximum improvement of segmental longitudinal deformation values was observed in the range of –13 to –5.5. Conclusion. The greatest improvement of segmental longitudinal myocardial deformation values (delta, –4.7) determined by speckle-tracking EchoCG occurred in the range of baseline values of –13 to –5.5, which corresponded to the hypokinetic area. In most cases, this improvement allows shifting these myocardial areas from hypokinetic to normokinetic.
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Gilyarov M.Yu., Murashova N.K., Novikova N.A. et al. Values of segmental longitudinal myocardial deformation at rest before and after coronary bypass surgery in patients with postinfarction cardiosclerosis. Russian Heart Journal. 2014;77 (3):131–135

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