rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2021-06-15rpcardio-2501Research ArticleNOTES FROM PRACTICEКЛИНИЧЕСКИЙ ОПЫТThe Effect of Clinical Characteristics and Stent Parameters on Left Ventricular Mechanical DyssynchronyВлияние клинических характеристик и параметров стента на механическую диссинхронию левого желудочкаhttps://orcid.org/0000-0002-5277-3377МостафаШ.MostafaS.

Шайма Мостафа

Shaimaa Mostafa

shaimaamustafa2011@gmail.comhttps://orcid.org/0000-0001-8734-2238СанадУ.SanadO.

Усама Санад

Osama Sanad

https://orcid.org/0000-0003-2798-1040ШокиМ.ShawkyM.

Махмуд Шоки

Mahmoud Shawky

https://orcid.org/0000-0003-2140-8964МагдиМ.MagdyM.

Мохамед Магди

Mohamed Magdy

https://orcid.org/0000-0001-7161-8041ЭлькешкЭ.ElkeshkE.

Эман Элькешк

Eman Elkeshk

Университет БенхаЕгипетBenha UniversityEgypt202112072021173438443Copyright © Mostafa S., Sanad O., Shawky M., Magdy M., Elkeshk E., 20212021Мостафа Ш., Санад У., Шоки М., Магди М., Элькешк Э.Mostafa S., Sanad O., Shawky M., Magdy M., Elkeshk E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/2501Aim

Aim. To study short term effect of stent size and number on left ventricular mechanical dyssynchrony after elective percutaneous coronary intervention (PCI) to left anterior descending (LAD) artery.

Materials and methods

Materials and methods. the study included 150 adult patients with LAD lesion treated with PCI using drug-eluting stent. Patients were evaluated pre PCI then 1 month and 3 months post PCI for evaluation of mechanical dyssynchrony using tissue synchronization image (TSI).

Results

Results. Before revascularization mean left ventricular ejection fraction was 51.2±5.7 %, mean time to peak TSI was 213.6±10.9 ms; 1 month after PCI TSI improved significantly to 163.7±17.6 ms (p<0.001), 3 months after PCI showed more improvement to 120.7±26.9 ms (p<0.001). After 3m; 61 patients (40.7%) showed recovery to normal TSI value. The predictors of non-improvement of time to peak TSI after 3 months were diabetes mellitus (p=0.007), dyslipidemia (p=0.001) and stent length (p=0.001), number of stents (p=0.004). There were strong negative correlation between stent length and improvement of the time to peak TSI at 1 month (r=-0.352, p<0.001) and at 3 months (r=-0.509, p<0.001),and also with number of stent at 1 month (r= -0.173, p=0.034) and at 3 months (r=-0.499, p<0.001), but the correlation between stent diameter and improvement of the TSI wasn’t significant neither at 1 month nor at 3 months (r=0.055, p=0.504 and r= -0.018, p=0.827) respectively.

Conclusion

Conclusion. Increased number and length of the implanted stents were predictors to non-improvement of mechanical dyssynchrony, while stent diameter didn’t affects the recovery.

Цель

Цель. Изучить краткосрочное влияние размера и количества стентов на механическую диссинхронию левого желудочка после планового чрескожного коронарного вмешательства (ЧКВ) на передней межжелудочковой артерии (ПМЖА).

Материалы и методы

Материалы и методы. В исследование были включены 150 взрослых пациентов с поражением ПМЖА, получавших ЧКВ с использованием стентов с лекарственным покрытием. Пациенты были обследованы до ЧКВ, а затем через 1 и 3 мес после ЧКВ для оценки механической диссинхронии с использованием методики тканевой синхронизации (TSI, tissue synchronization imaging).

Результаты

Результаты. До реваскуляризации средняя фракция выброса левого желудочка составляла 51,2±5,7%, среднее максимальное время TSI составляло 213,6±10,9 мс; через 1 мес после ЧКВ время TSI значительно улучшилось – до 163,7±17,6 мс (p<0,001); через 3 мес после ЧКВ было отмечено еще большее улучшение до 120,7±26,9 мс (p<0,001). Через 3 мес у 61 пациента (40,7%) наблюдалось восстановление TSI до нормального значения. Предикторами отсутствия улучшения времени TSI через 3 мес были: сахарный диабет (p=0,007), дислипидемия (p=0,001) и длина стента (p=0,001), количество стентов (p=0,004). Наблюдалась сильная отрицательная корреляция между длиной стента и улучшением времени достижения максимального значения TSI через 1 мес (r=-0,352, p<0,001) и через 3 мес (r=-0,509, p<0,001), а также с количеством стентов через 1 мес (r=-0,173, p=0,034) и через 3 мес (r=-0,499, p<0,001), но корреляция между диаметром стента и улучшением TSI была незначимой ни через 1 мес, ни через 3 мес (r=0,055, p=0,504 и r=-,018, p=0,827 соответственно).

Заключение

Заключение. Увеличение количества и длины имплантированных стентов являлись предикторами отсутствия улучшения механической диссинхронии, в то время как диаметр стента не влиял на восстановление.

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The authors declare that there are no conflicts of interest present.