DIAGNOSTIC SIGNIFICANCE OF NOVEL MARKERS FOR ASSESSMENT OF MYOCARDIUM CONDITION IN OBSTRUCTIVE DIFFUSE-GENERALIZED FORM OF HYPERTROPHIC CARDIOMYOPATHY

Aim. To evaluate informativity and relation of changes of galectin-3 (G3) and natriuretic brain peptide (BNP) in diagnostics of myocardium dysfunctions during analysis of surgical intervention in HCMP patients.

Material and methods. An analysis is presented, of 30 patients with diffusegeneralized type of hypertrophic cardiomyopathy (HCMP) (16 females and 14 males, mean age 53,7±2,8 y. o.), who during the time from 2009 to may 2016 in V. B. Petrovskiy Russian National Research Centre of Surgery, underwent the operation of extended myectomy. Before and after operation all patients underwent laboratory tests with measurement of the levels of BNP and G3 in serum, echocardiography, MRI/MSCT of the heart. Operations were done on-pump and pharmaco-cold cardioplegy.

Results. In transthoracal echocardiography there was significant decrease revealed, of interventricular septum thickness and gradient of ascending LV tractus, and nonsignificant enlargement of LV cavity during systole. In analysis of i. v. contrast MRI/MSCT of the heart in 26 patients there was non-significant increase of LV cavity during systole and decrease of LV mass in diastole. In analysis of serum BNP level as an important marker of clinical course and treatment efficacy, there was significant decrease of the values comparing to baseline in pre-operation period.

Conclusion. The extended myectomy surgery with parietal resection of papillary muscles makes it to reach good effect on an interventricular pressure gradient elimination in the space of whole ascending tractus of the left ventricle. Comparing to BNP that make it possible to evaluate the effectiveness of treatment, G3 is not so effective in diagnostics and there is yet no convincing evidence to confirm the value of G3 concentration in blood as an instrument that can be applied in monitoring of surgery effect.

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