Myocardial reserve in patients with myocardial infarction: the role of clinical and functional parameters in its assessment
Abstract
To identify the most informative characteristics of myocardial reserve (MR) inpatients with myocardial infarction (MI), the authors compared clinical symptoms of heart failure (HF), systolic and diastolic myocardial function, and left ventricular (LV) remodeling parameters. Data from 220 patients demonstrated that low LV ejection fraction was a significant predictor only for high HF functional class (FC). Diastolic dysfunction (DD) was typical for all HFFC, and restrictive type of heart filling was associated with HF FC III-IV. Concentric LV hypertrophy, as well as DD, was observed in all HF FC. Prevalence of eccentric hypertrophy significantly increased from 5,1% in FC 1to 98,7% in FC IV. This characterizes the latter process as most typical for MR decrease in MI patients. The authors propose a new gradation for MR decline, and discuss correlations among HF FC, DD, myocardial contractility, and myocardial remodeling.
About the Authors
A. P. Ivanov
Тверская медицинская академия, Тверской кардиологический диспансер
Russian Federation
Russian Federation
I. A. Elgardt
Тверская медицинская академия, Тверской кардиологический диспансер
Russian Federation
Russian Federation
V. A. Leontyev
Тверская медицинская академия, Тверской кардиологический диспансер
Russian Federation
Russian Federation
References
1. Бузиашвили Ю.И., Ключников И.В., Мелконян A.M. и др. Ишемическое ремоделирование левого желудочка (определение, патогенез, медикаментозная и хирургическая коррекция)//Кардиология. 2002. 10. 88-94.
2. Сидоренко Г.И., Фролов А.В. Модификация клинической классификации сердечной недостаточности с количественной оценкой функциональных нарушений//Кардиология 2002. 12.13-17.
3. Adamian K.G., Chilingarian A.L., Astvatsatrian A.V. et al. Adding losartan to standard therapy reduced total ishemic burden and heart rate variability in patients with postinfarction left ventricular remodeling and heart failure//Eur. HeartJ. 2000. 21. Abstr. Suppl. 331.
4. Asmar R., London G., Benetas A. et al. The REASON project: blood pressure evaluation//Am.J.Hypertens. 2001. 14. 115A
5. Cerisano G., Bolognese L. Echo-Doppler evaluation of left ventricular dysfunction during acute myocardial infarction: methodological, clinical and prognostic implications//Ital.Heart J. 2001. 2. 13-20.
6. Dahlof В., Agabiti-Rosei E., Zaliunas R. et al. Improvement in left ventricular function following treatment of hypertension with omapatrial us losartan//Eur.Heart J. 2000. Abstr. Suppl. 344 (A1847).
7. Harrington D., Anker S.D., Coats A.J.S. Preservation of exercise capacity and lack of peripheral changes in asymptomatic patients with severaly impaired left ventricular function//Eur.Heart J. 2001. 22. 392-399.
8. Lye M., Wisniacki N. Heart failure in the elderly: a diastolic problem?/EurJ.Heart Failure 2000. 2. 2. 133-136.
9. Nijland E., Kamp O., Verhorst P.M. et al. In-hospital and long-term prognostic value of viable myocardium detected by dobutamine stress echocardiography early after acute myocardial infarction and its relation to indicators of left ventricular dysfunction?//AmJ.Cardiol. 2001. 88. 949-955.
10. Remma W.J., Swedberg K. Task Forse for the Diagnosis and Treatment of Chronic Heart Failure. European Society of Cardiology//Eur.HeartJ. 2001. 22. 1527-1560.
11. Solomon S.D., Glynn R.J., Greaves S. et al. Recovery of ventricular function after myocardial infarction in the reperfusion era: the healing and early after long reducing therapy study//Ann.Intern.Med. 2001. 134. 451-458.
12. Wiilenheimer R., Dahlof В., Gordon A. Clinical trials in cardiovascular medicine: are wo looking for statistical significance or clinical relevance//Heart. 2000. 84. 129-133.
Review
For citations:
Ivanov A.P., Elgardt I.A., Leontyev V.A. Myocardial reserve in patients with myocardial infarction: the role of clinical and functional parameters in its assessment. Russian Journal of Cardiology. 2005;(5):16-19. (In Russ.)
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