rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2015-11-6-595-600rpcardio-438Research ArticleORIGINAL STUDIESОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯLeft ventricular remodeling in patients with right ventricular myocardial infarctionРЕМОДЕЛИРОВАНИЕ ЛЕВОГО ЖЕЛУДОЧКА У ПАЦИЕНТОВ С ИНФАРКТОМ МИОКАРДА ПРАВОГО ЖЕЛУДОЧКАБейшенкуловМ. Т.Beyshenkulov,M. T.

д.м.н., зав. отделением ургентной кардиологии и реанимации НЦКиТ им. академика М.М. Миррахимова

ЧазымоваЗ. М.ChazymovaZ. M.

н.с. того же отделения

АбылгазиеваА. С.AbylgazievaA. S.

м.н.с. того же отделения

КалиевК. Р.KalievK. R.

м.н.с. того же отделения

urgcard@gmail.comНациональный центр кардиологии и терапии им. академика М.Миррахимова Кыргызстан, 720040 Бишкек, ул.Тоголока Молдо, 3РоссияNational Center of Cardiology and Therapy named after Academician M.M. Mirrahimov Togoloka Moldo ul. 3, Bishkek, 720040 KyrgyzstanRussian Federation201530122015116595600Copyright © Beyshenkulov, M.T., Chazymova Z.M., Abylgazieva A.S., Kaliev K.R., 20152015Бейшенкулов М.Т., Чазымова З.М., Абылгазиева А.С., Калиев К.Р.Beyshenkulov, M.T., Chazymova Z.M., Abylgazieva A.S., Kaliev K.R.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/438Aim

Aim. To study left ventricular (LV) remodeling, interventricular and intraventricular asynchrony in isolated inferior LV myocardial infarction (MI) or combined inferior LV MI with right ventricular (RV) MI.

Material and methods

Material and methods. 57 patients with inferior LV MI with or without RV MI (n=57) were included in a 6-month prospective study. The patients were divided into 2 groups: Group 1 - patients with inferior LV MI (n=30); Group 2 - patients with inferior LV MI in combination with RV MI (n=27). Electrocardiography and echocardiography were performed in all patients at admission, on days 3, 30 and 180 after MI.

Results

Results. Significant signs of diastolic dysfunction (RV end-diastolic area 29.21±2.0 cm2) were found in group 2 on the third day after MI. A significant increase in the LV volume indices and diastolic sphericity index (from 0.54±0.02 to 0.59±0.03 units) and an increase in interventricular asynchrony (from 37.4±4.2 to 44.6±4.2 ms) were found in group 2 in 30 days after MI. Increasing tendency towards intraventricular and interventricular asynchrony, despite the absence of pathological LV remodeling, occurred in group 2 in 6 months after MI.

Conclusion

Conclusion. Patients with RV MI have more pronounced maladaptive LV remodeling, intraventricular and interventricular asynchrony and greater LV diastolic dysfunction.

Цель

Цель. Изучить ремоделирование левого желудочка (ЛЖ), межжелудочковую (МЖА) и внутрижелудочковую асинхронию (ВЖА) при изолированном инфаркте миокарда (ИМ) нижней стенки ЛЖ или сочетанном ИМ нижней стенки ЛЖ и правого желудочка (ПЖ).

Материал и методы

Материал и методы. В проспективное исследование длительностью 6 мес были включены 57 больных первичным нижним ИМ ЛЖ в сочетании или без ИМ ПЖ. Больные разделены на 2 группы: 1 группа – больные ИМ нижней стенки ЛЖ (n=30); 2 группа – больные ИМ нижней стенки ЛЖ в сочетании с ИМ ПЖ (n=27). Электрокардиография и эхокардиография (ЭхоКГ) проводились всем пациентам при поступлении, на 3, 30 и 180 дни после ИМ.

Результаты

Результаты. На 3 сутки после ИМ у больных 2 группы отмечались достоверные признаки систолической дисфункции ПЖ (конечно-диастолическая площадь ПЖ 29,21±2,0 см2). На 30 сутки после ИМ во 2 группе отмечено значимое увеличение объемных показателей ЛЖ, а также диастолического индекса сферичности (с 0,54±0,02 до 0,59±0,03 ед) и увеличение МЖА (с 37,4±4,2 до 44,6±4,2 мс). На 6 мес заболевания у больных 2 группы значения величин ВЖА и МЖА имели тенденцию к увеличению, несмотря на отсутствие патологического ремоделирования ЛЖ.

Заключение

Заключение. Пациенты с ИМ ПЖ имеют более выраженные процессы дезадаптивного ремоделирования ЛЖ и меж/внутрижелудочковой асинхронии, а также отмечается более выраженная диастолическая дисфункция ЛЖ.

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