Диастолическая дисфункция левого желудочка и прогноз у больных ишемической болезнью сердца с сердечной недостаточностью

Full text:  

 

Abstract

For last decade prevalence of heart failure (HF) with normal left ventricular ejection fraction makes up to 54% in all HF cases. We have decided to scrutinize the problem of expansion of prognosis parameters search for patients with the Coronary Heart Disease (CHD) and HF. There were included 119 patients with CHD with II-IV HF functional classes (NYHA) in research. The group of comparison was made by patients with CHD without HF (n=162). Patients were observed during a half of a year. The survival rate of patients was estimated. Patients received the standard treatment. There were registered 10 (3.6%) deaths in group of patients with HF. With the help of the multifactorial analysis we have allocated 7 significant prognosis parameters: diastolic dysfunction of the left ventricular, Е/Е', diastolic pressure in pulmonary artery, pulmonary embolism, cachexia, quantitative changes of carotids, index of end systolic dimensions of the left ventricular. With the help of the equation of linear regress we have calculated three degrees of risk of fatal outcome with sensitivity of 81.8%, and specificity of 86.4%.

References

1. Беленков, Ю. Н. Принципы рационального лечения сердечной недостаточности / Ю. Н. Беленков, В. Ю. Мареев. – М., 2000. – 266 c.

2. Гаман, С. А. Оценка распространенности и степени тяжести мультифокального атеросклероза с использованием методов электронно-лучевой компьютерной томографии и ультразвукового дуплексного сканирования у больных ишемической болезнью сердца: автореф. дис. … канд. мед. наук / С. А. Гаман. – М., 2004. – 28 с.

3. Грачев, А. В. Масса миокарда левого желудочка, его функциональное состояние и диастолическая функция сердца у больных артериальной гипертонией при различных эхокардиографических типах геометрии левого желудочка сердца / А. В. Грачев, А. Л. Аляви, Г. У. Ниязова, С. Б. Мостовщиков // Кардиология. – 2000. – № 3. – C. 31–38.

4. Лелюк, В. Г. Ультразвуковая ангиология / В. Г. Лелюк, С. Э. Лелюк. – 2-е изд. – М.: Реальное время, 2003. – 322 с.

5. Мартынов, А. И. Растяжимость аорты при артериальной гипертензии / А. И. Мартынов, О. Д. Остроумова, В. Е. Синицын и др. // Кардиология. – 2001. – № 2. – С. 59–65.

6. Хохлова, В. А. Диастолическая дисфункция левого желудочка у больных инфарктом миокарда: автореф. дис. … канд. мед. наук / В. А. Хох- лова. – М., 2009. – 24 с.

7. Arroyo-Espliguero, R. Chronic inflammation and increased arterial stiffness in patients with cardiac syndrome X / R. Arroyo-Espliguero, N. Mollichelli, P. Avanzas et al. // Eur. Heart J. – 2003. – Vol. 24. – P. 2006–2011.

8. Braunwald, E. Heart disease / E. Braunwald. – 8-th ed. – Philadelphia: W. B. Saunders company, 2007.

9. Bruch, C. Usefulness of tissue Doppler imaging for estimation of left ventricular filling pressures in patients with systolic and diastolic heart failure / C. Bruch, M. Grude, J. Muller et al. // Am. J. Cardiol. – 2005. – Vol. 95. – P. 892–895.

10. Сho, G. Global 2-Dimensional strain as a new prognosticator in patients with heart failure / G. Сho, T. H. Marwick, H. Kim et al. // J. Am. Coll. Cardiol. – 2009. – Vol. 54. – P. 618–624.

11. Ganau, A. Patterns of left ventricular hypertrophy and geometric remodeling in essential hypertension / A. Ganau, R. B. Devereux, M. J. Roman et al. // J. Am. Coll. Cardiol. – 1992. – Vol. 19. – P. 1550–1558.

12. Hillis, G. S. Noninvasive estimation of left ventricular filling pressure by E/e’ is a powerful predictor of survival after acute myocardial infarction / G. S. Hillis, J. E. Moller, P. A. Pellikka et al. // J. Am. Coll. Cardiol. – 2004. – Vol. 43. – P. 360–367.

13. Kirkpatrick, J. N. Echocardiography in heart failure applications, utility, and new horizons / J. N. Kirkpatrick, M. A. Vannan, J. Narula, R. M. Lang // J. Am. Coll. Cardiol. – 2007. – Vol. 50. – P. 381–396.

14. Lafitte, S. Do we need new echocardiographic prognosticators for the management of heart failure patients? / S. Lafitte // J. Am. Coll. Cardiol. – 2009. – Vol. 54. – P. 625–627.

15. Lang, R. M. Recommendations for chamber quantification / R. M. Lang, M. Bierig, R. B. Devereux et al. // Eur. J. Echocardiography. – 2006. – Vol. 7. – P. 79–108.

16. Lang, R. M. Recommendations for chamber quantification / R. M. Lang, M. Bierig, R. B. Devereaux et al. // J. Am. Soc. Echocardiogr. – 2005. – Vol. 18. – P. 1440–1463.

17. Lehmann, E. D. Terminology for the definition of arterial elastic properties / E. D. Lehmann // Path. Biol. – 1999. – Vol. 6. – P. 656–664.

18. Lester, S. J. Unlocking the mysteries of diastolic function. Deciphering the Rosetta Stone 10 years later / S. J. Lester, A. J. Tajik, R. A. Nishimura et al. // J. Am. Coll. Cardiol. – 2008. – Vol. 51. – P. 679–689.

19. Maeder, M. T. Heart failure with normal left ventricular ejection fraction / M. T. Maeder, D. M. Kaye // J. Am. Coll. Cardiol. – 2009. – Vol. 53. – P. 905–918.

20. Maurer, M. S. Diastolic dysfunction can it be diagnosed by Doppler echocardiography? / M. S. Maurer, D. Spevack, D. Burkhoff, I. Kronzon // J. Am. Coll. Cardiol. – 2004. – Vol. 44. – P. 1543–1549.

21. Ommen, S. R. А clinical approach to the assessment of left ventricular diastolic function by Doppler echocardiography: update 2003 / S. R. Ommen, R. A. Nishimura // Heart. – 2003. – Vol. 89. – P. iii18–iii23 (Suppl. 3).

22. Ommen, S. R. Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling How to diagnose diastolic heart failure Page 11 of 12 pressures: A comparative simultaneous Doppler-catheterization study / S. R. Ommen, R. A. Nishimura, C. P. Appleton et al. // Circulation. – 2000. – Vol. 102. – P. 1788–1794.

23. Paulus, W. J. How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology / W. J. Paulus, C. Tschope, F. J. E. Sanderson et al. // Eur. Heart J. – 2007. – Vol. 28. – P. 2539–2550.

24. Persson, H. Diastolic dysfunction in heart failure with preserved systolic function: need for objective evidence results from the CHARM echocardiographic substudy–CHARMES / H. Persson, E. Lonn, M. Edner et al. for the Investigators of the CHARM Echocardiographic Substudy– CHARMES // J. Am. Coll. Cardiol. – 2007. – Vol. 49. – P. 687–694.

25. Pritchett, A. M. Diastolic dysfunction and left atrial volume a population-based study / A. M. Pritchett, D. W. Mahoney, S. J. Jacobsen et al. // J. Am. Coll. Cardiol. – 2005. – Vol. 45. – P. 87–92.

26. Rihal, C. S. Systolic and diastolic dysfunction in patients with clinical diagnosis of dilated cardiomyopathy. Symptoms and prognosis / C. S. Rihal, R. A. Nishimura, L. K. Hatle et al. // Circulation. – 1994. – Vol. 90. – P. 2772–2779.

27. Rogers, W. J. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure / W. J. Rogers, D. E. Johnstone, S. Yusuf et al. // N. Engl. J. Med. – 1991. – Vol. 325. – P. 293–302.

28. Yu, C. M. Tissue Doppler imaging–a new prognosticator for cardiovascular diseases / C. M. Yu, J. E. Sanderson, H. T. Marwick, K. H. Oh // J. Am. Coll. Cardiol. – 2007. – Vol. 49. – P. 1903–1914.

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery