The Structure of Left Ventricular Relaxation in Case of Ventriculography.

IF 0.5 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Kardiologiya Pub Date : 2024-08-31 DOI:10.18087/cardio.2024.8.n2640

V L Lakomkin, A A Abramov, A V Prosvirnin, A S Tereshchenko, G K Arutunan, A N Samko, V I Kapelko

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Abstract

Aim: To study the relaxation structure of the left ventricle (LV) in patients who underwent ventriculography.

Material and methods: LV ventriculography was performed in 37 patients. Before catheterization, echocardiography was performed in each patient. In 6 patients, the LV ejection fraction (EF) was below 40%; these patients with systolic dysfunction were not included in the study. In 31 patients, the LV EF was higher than 50%. In this group, 13 patients had NYHA functional class (FC) 2-3 chronic heart failure (CHF); the rest of the patients had FC 1 CHF. Eighteen of 31 patients had stable ischemic heart disease; 50% of these patients had a history of myocardial infarction; the rest of the patients had hypertension and atrial and ventricular arrhythmias. The dynamics of the LV pressure decrease was analyzed from the moment of the maximum rate of pressure drop, which usually coincides with the closure of the aortic valves. The pressure drop curve was logarithmized with natural logarithms and divided into 4-5 sections with different degrees of curve slope. The relaxation time constant was calculated for each section. Its inverse value characterizes the relaxation time constant (tau).

Results: In 31 patients with LV EF 52-60%, three types of the dynamics of the relaxation rate constant were identified during the pressure decrease in the isovolumic phase: in 9 patients, the isovolumic relaxation constant (IRC) steadily increased as the pressure decreased; in 13 patients, it continuously decreased; and in 9 patients, the dynamics of IRC change was intermediate, with an initial increase followed by a decrease.

Conclusion: In diastolic dysfunction, one group of patients had an adaptation type associated with an increase in the LV wall elasticity, while the other group had a different type of adaptation associated with its decrease. Each type has advantages and disadvantages. This is probably due to changes in the structure of the sarcomeric protein connectin (titin).

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心室造影中左心室舒张的结构。

目的：研究接受心室造影术的患者左心室的松弛结构：37名患者接受了左心室造影术。材料：对 37 名患者进行了左心室造影检查，每位患者在导管插入术前都进行了超声心动图检查。6名患者的左心室射血分数（EF）低于40%，这些收缩功能障碍患者未纳入研究。31名患者的左心室射血分数高于50%。在这组患者中，13 名患者患有 NYHA 功能分级（FC）2-3 级慢性心力衰竭（CHF），其余患者患有 FC 1 级慢性心力衰竭。31名患者中有18名患有稳定的缺血性心脏病，其中50%有心肌梗死病史，其余患者患有高血压、房性和室性心律失常。左心室压力下降的动态分析是从压力下降速率最大的时刻开始的，而压力下降速率最大的时刻通常与主动脉瓣关闭的时间相吻合。用自然对数对压力下降曲线进行对数化处理，并将其分为 4-5 段，每段的曲线斜率各不相同。计算每个部分的松弛时间常数。其倒数表示松弛时间常数（tau）：在 31 例左心室 EF 值为 52-60% 的患者中，发现等容阶段压力下降时松弛率常数的动态变化有三种类型：9 例患者的等容松弛常数（IRC）随压力下降而稳步上升；13 例患者的等容松弛常数持续下降；9 例患者的等容松弛常数的动态变化处于中间状态，最初上升，随后下降：结论：在舒张功能障碍患者中，一组患者的适应类型与左心室壁弹性增加有关，而另一组患者的适应类型与左心室壁弹性降低有关。两种类型各有利弊。这可能是由于肉瘤蛋白连接蛋白（titin）的结构发生了变化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Kardiologiya 医学-心血管系统

CiteScore

1.70

自引率

20.00%

发文量

审稿时长

3-8 weeks

期刊介绍： “Kardiologiya” (Cardiology) is a monthly scientific, peer-reviewed journal committed to both basic cardiovascular medicine and practical aspects of cardiology. As the leader in its field, “Kardiologiya” provides original coverage of recent progress in cardiovascular medicine. We publish state-of-the-art articles integrating clinical and research activities in the fields of basic cardiovascular science and clinical cardiology, with a focus on emerging issues in cardiovascular disease. Our target audience spans a diversity of health care professionals and medical researchers working in cardiovascular medicine and related fields. The principal language of the Journal is Russian, an additional language – English (title, authors’ information, abstract, keywords). “Kardiologiya” is a peer-reviewed scientific journal. All articles are reviewed by scientists, who gained high international prestige in cardiovascular science and clinical cardiology. The Journal is currently cited and indexed in major Abstracting & Indexing databases: Web of Science, Medline and Scopus. The Journal''s primary objectives Contribute to raising the professional level of medical researchers, physicians and academic teachers. Present the results of current research and clinical observations, explore the effectiveness of drug and non-drug treatments of heart disease, inform about new diagnostic techniques; discuss current trends and new advancements in clinical cardiology, contribute to continuing medical education, inform readers about results of Russian and international scientific forums; Further improve the general quality of reviewing and editing of manuscripts submitted for publication; Provide the widest possible dissemination of the published articles, among the global scientific community; Extend distribution and indexing of scientific publications in major Abstracting & Indexing databases.