Pub Date : 2022-09-26DOI: 10.30702/ujcvs/22.30(03)/dk032-2934
I. Davydova, I. G. Kryvorchuk, S. O. Siromakha, A. Lymanska, O. Kravets
Over the past twenty years, it has been proven that a history of preeclampsia entails a 4-fold risk of hypertension, coronary heart disease, stroke, type 2 diabetes, metabolic syndrome in the affected women at the age of 50-55 years. Evaluation of intima-media thickness (IMT) has diagnostic value for the assessment of remodeling and atherosclerotic vascular lesions and practical importance as a predictor of vascular accidents in patients with hypertension and atherosclerosis. The aim. To evaluate the IMT as an integrative biomarker of the occurrence of cardiovascular pathology in women with hypertensive disorders of pregnancy in their advanced reproductive age and in perimenopausal age. Materials and methods. We studied 51 women at the age of 48-55 years with the history of severe preeclampsia. The women were asked to fill out a questionnaire in which they indicated the presence of a diagnosis of hypertension, angina pectoris at the time of filling the questionnaire. The diagnosis of hypertension and angina attacks as well as other descriptions of the disease were taken away from the results of the women’s questionnaire. The investigators were not given copies of medical records. The control group consisted of 20 women aged 48-55 who had no history of preeclampsia or any other hypertensive disorders of pregnancy. Ultrasound imaging of the carotid arteries was performed according to the recommendations of the American Society of Echocardiography 2020 in women of both groups using SonoAce-8000 Ex scanner (Medison, South Korea) with a linear sensor UST5524 with a frequency of 7 MHz. IMT less than 0.7 mm was taken as a normal value for women. Results. It was revealed that almost every fourth woman at the age of 48-55 with the history of preeclampsia had signs of early angina attacks, and 30% suffered from hypertension. A threatening fact is that almost 6% of women at the age of 48-55 had the history of vascular thrombosis which is a manifestation of early atherosclerotic vascular lesions in the group of women with gestational hypertensive disorders. It is noteworthy that 21 (41.2%) women with the history of severe preeclampsia felt healthy and did not have any complaints. Importantly, among the women surveyed who had no health complaints, 66.6% (14 of 21) had IMT 0.85±0.01 mm. This accounts for about one third (27.4%) among 51 patients. This category of women is at high risk of developing cardiovascular complications in the future and require further monitoring and detailed examination. Thrombotic complications (dynamic bowel obstruction, mesenteric vascular thrombosis) were observed in 3 (5.9 %) women at the age of 48-55 with the history of severe preeclampsia. Conclusions. Examinations of women with the history of preeclampsia revealed that women at the age of 48-55 had increased IMT. It should be noted that increased IMT was found both in women with cardiovascular pathology (hypertension, thrombosis, angina attacks) and in asymptomatic patient
{"title":"Intima-Media Thickness in Women with the History of Hypertensive Disorders of Pregnancy as a Risk Marker of the Occurrence of Cardiovascular Pathology in Advanced Reproductive and Perimenopausal Age","authors":"I. Davydova, I. G. Kryvorchuk, S. O. Siromakha, A. Lymanska, O. Kravets","doi":"10.30702/ujcvs/22.30(03)/dk032-2934","DOIUrl":"https://doi.org/10.30702/ujcvs/22.30(03)/dk032-2934","url":null,"abstract":"Over the past twenty years, it has been proven that a history of preeclampsia entails a 4-fold risk of hypertension, coronary heart disease, stroke, type 2 diabetes, metabolic syndrome in the affected women at the age of 50-55 years. Evaluation of intima-media thickness (IMT) has diagnostic value for the assessment of remodeling and atherosclerotic vascular lesions and practical importance as a predictor of vascular accidents in patients with hypertension and atherosclerosis. \u0000The aim. To evaluate the IMT as an integrative biomarker of the occurrence of cardiovascular pathology in women with hypertensive disorders of pregnancy in their advanced reproductive age and in perimenopausal age. \u0000Materials and methods. We studied 51 women at the age of 48-55 years with the history of severe preeclampsia. The women were asked to fill out a questionnaire in which they indicated the presence of a diagnosis of hypertension, angina pectoris at the time of filling the questionnaire. The diagnosis of hypertension and angina attacks as well as other descriptions of the disease were taken away from the results of the women’s questionnaire. The investigators were not given copies of medical records. The control group consisted of 20 women aged 48-55 who had no history of preeclampsia or any other hypertensive disorders of pregnancy. Ultrasound imaging of the carotid arteries was performed according to the recommendations of the American Society of Echocardiography 2020 in women of both groups using SonoAce-8000 Ex scanner (Medison, South Korea) with a linear sensor UST5524 with a frequency of 7 MHz. IMT less than 0.7 mm was taken as a normal value for women. \u0000Results. It was revealed that almost every fourth woman at the age of 48-55 with the history of preeclampsia had signs of early angina attacks, and 30% suffered from hypertension. A threatening fact is that almost 6% of women at the age of 48-55 had the history of vascular thrombosis which is a manifestation of early atherosclerotic vascular lesions in the group of women with gestational hypertensive disorders. It is noteworthy that 21 (41.2%) women with the history of severe preeclampsia felt healthy and did not have any complaints. Importantly, among the women surveyed who had no health complaints, 66.6% (14 of 21) had IMT 0.85±0.01 mm. This accounts for about one third (27.4%) among 51 patients. This category of women is at high risk of developing cardiovascular complications in the future and require further monitoring and detailed examination. Thrombotic complications (dynamic bowel obstruction, mesenteric vascular thrombosis) were observed in 3 (5.9 %) women at the age of 48-55 with the history of severe preeclampsia. \u0000Conclusions. Examinations of women with the history of preeclampsia revealed that women at the age of 48-55 had increased IMT. It should be noted that increased IMT was found both in women with cardiovascular pathology (hypertension, thrombosis, angina attacks) and in asymptomatic patient","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46803465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-26DOI: 10.30702/ujcvs/22.30(03)/h045-8392
N. Hrabovskyy
The article presents the principles of providing care for injuries to the heart, aorta, pulmonary artery, or other main vessels. The described principles can be applied in the treatment of civil injuries. The aim. Consider a treatment tactic in the cases of heart and main vessels combat injuries using own experience. Materials and methods. Twelve cases of combat wounds of blood circulation organs in the chest were analyzed: 5 gunshot injuries of the subclavian vessels, 4 gunshot injuries of the heart, 1 gunshot injury of the ascending aorta, 1 gunshot injury of the pulmonary artery and 1 suspected gunshot injury of the left ventricle. Also we analyzed 78 cases of combat gunshot injuries of main vessels of other locations: 3 injuries of vessels of the neck, 68 injuries of main vessels of limbs, 6 injuries of iliac arteries, 1 injury of abdominal aorta. Most of the operations, with the exception of those that required artificial blood circulation, were performed in advanced hospitals at the II level of military medical evacuation, which enabled to shorten the time from injury to the performance of the final surgical intervention and save life or limbs. Results and discussion. Two cases with penetrating wounds to the chest and damage to the subclavian vessels were fatal. Death was attributed to uncontrolled chest bleeding. Among the 78 cases of injury of main vessels of other locations, one case with damage to the iliac arteries was fatal, and death also occurred as a result of uncontrolled massive intra-abdominal bleeding. Conclusions. Wounded individuals with unstable hemodynamics against the background of ongoing massive bleeding and with suspicion of injury of the heart or main vessels in the chest should be operated on immediately. Due to the urgency of performing such operations and impossibility of an adequate additional examination, localization and degree of the damage to the organs of the circulatory system is determined during the operation. A thoracoscopic approach can be used in stable patients with non-penetrating gunshot wounds to the heart. In the relatively stable condition of patients with an established injury of the heart, aorta, or pulmonary artery, it is advisable to perform additional examinations. Patients with trauma to the main vessels of the extremities and ischemia thereof need rapid revascularization.
{"title":"Experience in the Treatment of Wounds of Circulatory Organs in the Chest and Main Vessels of Other Localizations in Wartime","authors":"N. Hrabovskyy","doi":"10.30702/ujcvs/22.30(03)/h045-8392","DOIUrl":"https://doi.org/10.30702/ujcvs/22.30(03)/h045-8392","url":null,"abstract":"The article presents the principles of providing care for injuries to the heart, aorta, pulmonary artery, or other main vessels. The described principles can be applied in the treatment of civil injuries. \u0000The aim. Consider a treatment tactic in the cases of heart and main vessels combat injuries using own experience. \u0000Materials and methods. Twelve cases of combat wounds of blood circulation organs in the chest were analyzed: 5 gunshot injuries of the subclavian vessels, 4 gunshot injuries of the heart, 1 gunshot injury of the ascending aorta, 1 gunshot injury of the pulmonary artery and 1 suspected gunshot injury of the left ventricle. \u0000Also we analyzed 78 cases of combat gunshot injuries of main vessels of other locations: 3 injuries of vessels of the neck, 68 injuries of main vessels of limbs, 6 injuries of iliac arteries, 1 injury of abdominal aorta. \u0000Most of the operations, with the exception of those that required artificial blood circulation, were performed in advanced hospitals at the II level of military medical evacuation, which enabled to shorten the time from injury to the performance of the final surgical intervention and save life or limbs. \u0000Results and discussion. Two cases with penetrating wounds to the chest and damage to the subclavian vessels were fatal. Death was attributed to uncontrolled chest bleeding. \u0000Among the 78 cases of injury of main vessels of other locations, one case with damage to the iliac arteries was fatal, and death also occurred as a result of uncontrolled massive intra-abdominal bleeding. \u0000Conclusions. Wounded individuals with unstable hemodynamics against the background of ongoing massive bleeding and with suspicion of injury of the heart or main vessels in the chest should be operated on immediately. Due to the urgency of performing such operations and impossibility of an adequate additional examination, localization and degree of the damage to the organs of the circulatory system is determined during the operation. A thoracoscopic approach can be used in stable patients with non-penetrating gunshot wounds to the heart. \u0000In the relatively stable condition of patients with an established injury of the heart, aorta, or pulmonary artery, it is advisable to perform additional examinations. Patients with trauma to the main vessels of the extremities and ischemia thereof need rapid revascularization.","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42717682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-26DOI: 10.30702/ujcvs/22.30(03)/km043-6067
H. B. Koltunova, A. Mazur, Oleksii A. Krykunov, Kostiantyn P. Chyz, Larysa A. Klymenko
Cardiorenal interaction in acute heart failure (AHF) is becoming an increasingly recognized factor to consider in the management of cardiac surgical patients. Achieving adequate control of water balance and simultaneously preserving kidney function is the goal of the optimal management strategy for patients with AHF. The majority of preoperative hospitalizations to intensive care units in patients with infective endocarditis (IE) are associated with the development of AHF. The term “cardiorenal syndrome” (CRS) is used to define kidney dysfunction on the background of AHF. Due to the lack of clear clinical manifestations of CRS in IE, the diagnosis and treatment of this pathology may be delayed and contribute to the increase in the number of postoperative complications. Recent data, both in basic science and in clinical research, have changed our understanding of CRS. To date, several types of impaired interaction between the kidneys and the heart have been identified. The aim. To study the peculiarities of CRS in patients with IE complicated by AHF. Materials and methods. The basis of this study was the clinical data of 41 patients with active IE who were treated at the National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine from 1/1/2020 to 8/31/2020. In order to study the features of clinical manifestation and the course of CRS, a comparative analysis was conducted based on the history and results of laboratory and instrumental research for the group of patients with IE complicated by preoperative AHF, and patients without clinical manifestations of AHF at the time of hospitalization. For an in-depth study of myocardial damage in heart failure, troponin, NT-proBNP, lactate levels were analyzed; dysfunction of the urinary system was assessed by the level of urea and serum creatinine, the volume of diuresis. Results. A reliable relationship between the levels of NT-proBNP and serum creatinine at the preoperative stage was revealed (p˂0.001), as an indicator of the presence of CRS in patients with IE. In the early postoperative period, signs of CRS persisted in patients with IE complicated by preoperative AHF (serum creatinine 157.0±8.5 μmol/l [p<0.001], NT-proBNP 8214.9±2390.0 pg/ml [p=0.010]). Normalization of kidney function indicators was reported on the day 14 after surgery. Conclusions. Cardiac surgical intervention in patients with IE contributes to reduction of CRS manifestations on the day 14 of the postoperative period.
{"title":"Cardiorenal Syndrome in Patients with Infective Endocarditis Complicated by Acute Heart Failure","authors":"H. B. Koltunova, A. Mazur, Oleksii A. Krykunov, Kostiantyn P. Chyz, Larysa A. Klymenko","doi":"10.30702/ujcvs/22.30(03)/km043-6067","DOIUrl":"https://doi.org/10.30702/ujcvs/22.30(03)/km043-6067","url":null,"abstract":"Cardiorenal interaction in acute heart failure (AHF) is becoming an increasingly recognized factor to consider in the management of cardiac surgical patients. Achieving adequate control of water balance and simultaneously preserving kidney function is the goal of the optimal management strategy for patients with AHF. The majority of preoperative hospitalizations to intensive care units in patients with infective endocarditis (IE) are associated with the development of AHF. The term “cardiorenal syndrome” (CRS) is used to define kidney dysfunction on the background of AHF. Due to the lack of clear clinical manifestations of CRS in IE, the diagnosis and treatment of this pathology may be delayed and contribute to the increase in the number of postoperative complications. Recent data, both in basic science and in clinical research, have changed our understanding of CRS. To date, several types of impaired interaction between the kidneys and the heart have been identified. \u0000The aim. To study the peculiarities of CRS in patients with IE complicated by AHF. \u0000Materials and methods. The basis of this study was the clinical data of 41 patients with active IE who were treated at the National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine from 1/1/2020 to 8/31/2020. In order to study the features of clinical manifestation and the course of CRS, a comparative analysis was conducted based on the history and results of laboratory and instrumental research for the group of patients with IE complicated by preoperative AHF, and patients without clinical manifestations of AHF at the time of hospitalization. For an in-depth study of myocardial damage in heart failure, troponin, NT-proBNP, lactate levels were analyzed; dysfunction of the urinary system was assessed by the level of urea and serum creatinine, the volume of diuresis. \u0000Results. A reliable relationship between the levels of NT-proBNP and serum creatinine at the preoperative stage was revealed (p˂0.001), as an indicator of the presence of CRS in patients with IE. In the early postoperative period, signs of CRS persisted in patients with IE complicated by preoperative AHF (serum creatinine 157.0±8.5 μmol/l [p<0.001], NT-proBNP 8214.9±2390.0 pg/ml [p=0.010]). Normalization of kidney function indicators was reported on the day 14 after surgery. \u0000Conclusions. Cardiac surgical intervention in patients with IE contributes to reduction of CRS manifestations on the day 14 of the postoperative period.","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42739180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-24DOI: 10.30702/ujcvs/22.30(02)/gl018-1316
A. Y. Gavrylyshyn
Selective coronary angiography (CAG) is an invasive diagnostic method for the assessment of the internal lumen and anatomical features of the coronary artery. This is a routine procedure and the basis for choosing the tactics of management of patients with coronary artery disease (CAD). However, CAG is a two-dimensional imaging, and despite the use of the poly projection imaging, there may be difficulties in assessing of the degree of stenosis (even by experienced operators, especially in 50–70% lesions). Along with multivessel disease (stenostes of 2 or more main coronary arteries with a diameter of more than 2 mm), this may cause difficulties in interpreting the results of the study and choosing further volume of revascularization (the number of treated stenosis). In these cases, it is necessary to use a combination of CAG with additional functional methods for diagnosing the significance of each coronary stenosis and its role in the occurrence of myocardial ischemia. The aim. To analyze the clinical results of stenting with invasive measurement of fractional flow reserve when choosing the volume of revascularization of 50–70% coronary artery stenoses. Materials and methods. The results of interventions in 109 patients treated at the National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine from 2017 to 2022 with CAD were studied; in these patients, CAG revealed >50–70% multivessel coronary artery disease. They were divided into two groups: fractional reserve group (main group) undergoing stenting of only symptomatic stenosis according to intracoronary physiological examination (n = 52; 47%), and control group (anatomical revascularization, n = 57; 53%) where stenting was determined according to angiography. Conclusion. Interventional treatment of multivessel CAD with fractional flow reserve assessment enables to avoid inappropriate stenting of hemodynamically insignificant stenoses, thus it is possible to optimize treatment tactics of this group of patients (reduce the number of implanted stents).
{"title":"The Role of Fractional Flow Reserve in Interventional Treatment of Multivessel Coronary Artery Disease","authors":"A. Y. Gavrylyshyn","doi":"10.30702/ujcvs/22.30(02)/gl018-1316","DOIUrl":"https://doi.org/10.30702/ujcvs/22.30(02)/gl018-1316","url":null,"abstract":"Selective coronary angiography (CAG) is an invasive diagnostic method for the assessment of the internal lumen and anatomical features of the coronary artery. This is a routine procedure and the basis for choosing the tactics of management of patients with coronary artery disease (CAD). However, CAG is a two-dimensional imaging, and despite the use of the poly projection imaging, there may be difficulties in assessing of the degree of stenosis (even by experienced operators, especially in 50–70% lesions). Along with multivessel disease (stenostes of 2 or more main coronary arteries with a diameter of more than 2 mm), this may cause difficulties in interpreting the results of the study and choosing further volume of revascularization (the number of treated stenosis). In these cases, it is necessary to use a combination of CAG with additional functional methods for diagnosing the significance of each coronary stenosis and its role in the occurrence of myocardial ischemia. \u0000The aim. To analyze the clinical results of stenting with invasive measurement of fractional flow reserve when choosing the volume of revascularization of 50–70% coronary artery stenoses. \u0000Materials and methods. The results of interventions in 109 patients treated at the National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine from 2017 to 2022 with CAD were studied; in these patients, CAG revealed >50–70% multivessel coronary artery disease. They were divided into two groups: fractional reserve group (main group) undergoing stenting of only symptomatic stenosis according to intracoronary physiological examination (n = 52; 47%), and control group (anatomical revascularization, n = 57; 53%) where stenting was determined according to angiography. \u0000Conclusion. Interventional treatment of multivessel CAD with fractional flow reserve assessment enables to avoid inappropriate stenting of hemodynamically insignificant stenoses, thus it is possible to optimize treatment tactics of this group of patients (reduce the number of implanted stents).","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42123454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-24DOI: 10.30702/ujcvs/22.30(02)/at028-7882
P. O. Almiz, A. Topchii
In 1992, Brugada brothers first described the clinical-electrocardiographic syndrome which was characterized by changes in the electrocardiogram (ECG), family history of syncopal states and sudden cardiac death (SCD) in the absence of structural heart disease. The standard therapy recommended by the European Society of Cardiology for the prevention of SCD in type I Brugada syndrome (BS) is implantation of a cardioverter-defibrillator. Radiofrequency ablation (RFA) of BS has been performed since the 2000s as an alternative therapy for BS with recurrent ventricular arrhythmias. To date, more than 300 such interventions have been performed by various centers around the world, and multicenter randomized trials are underway to study the long-term results of catheter destruction. We reviewed our experience of catheter ablation in a patient with BS. The patient suffered from ventricular arrhythmias and short-term loss of consciousness. ECG and 24-hour monitoring data recorded ventricular arrhythmias of more than 34% per day and type II BS. Electroanatomical mapping and RFA of the areas with low amplitude graphics were performed by endocardial access. This zone coincided with the earliest activation of the myocardium during ventricular arrhythmias. Extrasystoles were eliminated. In the remote period (10-12 weeks) the patient had no ventricular arrhythmias and there are also no ECG signs of BS. Most major arrhythmological centers perform RFA with epicardial access. Our patient chose the endocardial approach as safer. In her specific case, localization of arimogenic substrate allowed to limit this access, and RFA was successful.
{"title":"Radiofrequency Ablation in Brugada Syndrome","authors":"P. O. Almiz, A. Topchii","doi":"10.30702/ujcvs/22.30(02)/at028-7882","DOIUrl":"https://doi.org/10.30702/ujcvs/22.30(02)/at028-7882","url":null,"abstract":"In 1992, Brugada brothers first described the clinical-electrocardiographic syndrome which was characterized by changes in the electrocardiogram (ECG), family history of syncopal states and sudden cardiac death (SCD) in the absence of structural heart disease. The standard therapy recommended by the European Society of Cardiology for the prevention of SCD in type I Brugada syndrome (BS) is implantation of a cardioverter-defibrillator. Radiofrequency ablation (RFA) of BS has been performed since the 2000s as an alternative therapy for BS with recurrent ventricular arrhythmias. To date, more than 300 such interventions have been performed by various centers around the world, and multicenter randomized trials are underway to study the long-term results of catheter destruction. We reviewed our experience of catheter ablation in a patient with BS. The patient suffered from ventricular arrhythmias and short-term loss of consciousness. ECG and 24-hour monitoring data recorded ventricular arrhythmias of more than 34% per day and type II BS. Electroanatomical mapping and RFA of the areas with low amplitude graphics were performed by endocardial access. This zone coincided with the earliest activation of the myocardium during ventricular arrhythmias. Extrasystoles were eliminated. In the remote period (10-12 weeks) the patient had no ventricular arrhythmias and there are also no ECG signs of BS. \u0000Most major arrhythmological centers perform RFA with epicardial access. Our patient chose the endocardial approach as safer. In her specific case, localization of arimogenic substrate allowed to limit this access, and RFA was successful.","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41793589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-24DOI: 10.30702/ujcvs/22.30(02)/sg024-6771
S. V. Salo, A. Y. Gavrylyshyn, O. Levchyshyna, S. S. Shpak
Background. The current state of interventional cardiology is aimed at reducing the number of probable complica-tions of procedures and increasing patient comfort. That is why there was a stage evolution of changing endovascular ap-proaches from transfemoral to transradial. But despite the significant benefits of transradial access, it leaves behind some important complications. One such complication is occlusion of the radial artery. The frequency of this situation ranges from 1 to 30%. That is why the world’s leading interventionists are increasingly using distal transradial access, which is associated with fewer cases of postoperative occlusion of the radial artery. The aim. Occlusion of the radial artery is not an obstacle to changing access to the contralateral artery or more dan-gerous transfemoral access. With distal transradial access it is possible to recanalize artery and provide target procedure. Materials and methods. The study included 318 patients who were scheduled for re-intervention. Among these patients, 12 had a radial artery occlusion, which is 3.7% of the total control group. Successful recanalizations with distal access were performed in 9 patients (75%), and in 3 patients (25%) the attempts were unsuccessful. The technique of recanalization of chronic occlusion included selection of hydrophilic, both non-coronary and coronary wires. At the end of the procedure, hemostasis was performed according to standard procedures using aseptic bandages. Complications of hemostasis were not detected in any patient in the control group. The postoperative period was unremarkable. Conclusions. The study showed the possibility of using distal transradial access to recanalize chronic occlusions of the radial artery, which allows not to waste time on replacement of the contralateral radial artery or life-threatening transfemoral access and perform the necessary amount of the intervention. Besides, this preserves the radial artery for further use in bypass surgery or hemodialysis arteriovenous fistula.
{"title":"Distal Transradial Access for Recanalization of Chronic Occlusions of the Radial Artery","authors":"S. V. Salo, A. Y. Gavrylyshyn, O. Levchyshyna, S. S. Shpak","doi":"10.30702/ujcvs/22.30(02)/sg024-6771","DOIUrl":"https://doi.org/10.30702/ujcvs/22.30(02)/sg024-6771","url":null,"abstract":"Background. The current state of interventional cardiology is aimed at reducing the number of probable complica-tions of procedures and increasing patient comfort. That is why there was a stage evolution of changing endovascular ap-proaches from transfemoral to transradial. But despite the significant benefits of transradial access, it leaves behind some important complications. One such complication is occlusion of the radial artery. The frequency of this situation ranges from 1 to 30%. That is why the world’s leading interventionists are increasingly using distal transradial access, which is associated with fewer cases of postoperative occlusion of the radial artery. \u0000The aim. Occlusion of the radial artery is not an obstacle to changing access to the contralateral artery or more dan-gerous transfemoral access. With distal transradial access it is possible to recanalize artery and provide target procedure. \u0000Materials and methods. The study included 318 patients who were scheduled for re-intervention. Among these patients, 12 had a radial artery occlusion, which is 3.7% of the total control group. Successful recanalizations with distal access were performed in 9 patients (75%), and in 3 patients (25%) the attempts were unsuccessful. The technique of recanalization of chronic occlusion included selection of hydrophilic, both non-coronary and coronary wires. At the end of the procedure, hemostasis was performed according to standard procedures using aseptic bandages. Complications of hemostasis were not detected in any patient in the control group. The postoperative period was unremarkable. \u0000Conclusions. The study showed the possibility of using distal transradial access to recanalize chronic occlusions of the radial artery, which allows not to waste time on replacement of the contralateral radial artery or life-threatening transfemoral access and perform the necessary amount of the intervention. Besides, this preserves the radial artery for further use in bypass surgery or hemodialysis arteriovenous fistula.","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46357419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-24DOI: 10.30702/ujcvs/22.30(02)/vk021-3438
R. M. Vitovskyi, O. V. Kupchynskyi, Ihor V. Martyshchenko, Maryna M. Serdiuk, V. Kupchinsky, V. Isaienko
Introduction. Cardiac tumors (CT) occur in 0.3-0.7% of general population according to autopsies. The combination of CT with coronary artery disease (CAD) significantly complicates the clinical course of the disease. The aim. To study the frequency, features of the course and surgical treatment of patients with CT combined with CAD. Materials and methods. In the period from 01.01.1969 to 31.12.2020, surgical treatment of 976 patients with CT was performed at the National Amosov Institute of Cardiovascular Surgery of the NAMS of Ukraine, and 41 (4.2%) of these patients had lesions of the coronary arteries. In 39 patients (95.1%), CT were represented by benign tumors (myxomas), in 2 (2.4%) by malignant, poorly differentiated sarcoma and immature teratoma. For the correction of the pathology of coronary vessels, a whole range of surgical methods was used: stenting of left anterior descending artery (LAD), which was performed immediately before surgery to remove CT, in 3 patients (7.3%); coronary artery bypass grafting in 35 patients (85.4%); in cases of the presence of a muscular bridge that narrowed the LAD, dissection of this structure was performed in 2 patients (4.9%); left ventricular aneurysm repair surgery in 1 patient (2.4%). In 7 patients (17.1%), the operation was performed on urgent indications. Results. The average number of grafted arteries was 1.9 ± 0.3 (1 to 4) per patient. There were no mortality. Of the 41 patients with coronary artery lesions with CT, there were 2 cases of acute CAD as a result of their embolism by tumor fragments. Clinical manifestations in these patients differed significantly. Conclusions. Occurrence of coronary artery embolism in patients with CT according to our data is 0.2% of all patients with CT. CAD accompanies tumor lesions in 4.1% of cases and is diagnosed by angiography and computed tomography. To correct the lesion of the coronary arteries in CT, the full range of surgical techniques is used, including stenting of the coronary artery (spacecraft), coronary artery bypass grafting, removal of the myocardial bridge.
{"title":"Surgical Treatment of Cardiac Tumors Combined with Coronary Pathology","authors":"R. M. Vitovskyi, O. V. Kupchynskyi, Ihor V. Martyshchenko, Maryna M. Serdiuk, V. Kupchinsky, V. Isaienko","doi":"10.30702/ujcvs/22.30(02)/vk021-3438","DOIUrl":"https://doi.org/10.30702/ujcvs/22.30(02)/vk021-3438","url":null,"abstract":"Introduction. Cardiac tumors (CT) occur in 0.3-0.7% of general population according to autopsies. The combination of CT with coronary artery disease (CAD) significantly complicates the clinical course of the disease. \u0000The aim. To study the frequency, features of the course and surgical treatment of patients with CT combined with CAD. \u0000Materials and methods. In the period from 01.01.1969 to 31.12.2020, surgical treatment of 976 patients with CT was performed at the National Amosov Institute of Cardiovascular Surgery of the NAMS of Ukraine, and 41 (4.2%) of these patients had lesions of the coronary arteries. In 39 patients (95.1%), CT were represented by benign tumors (myxomas), in 2 (2.4%) by malignant, poorly differentiated sarcoma and immature teratoma. For the correction of the pathology of coronary vessels, a whole range of surgical methods was used: stenting of left anterior descending artery (LAD), which was performed immediately before surgery to remove CT, in 3 patients (7.3%); coronary artery bypass grafting in 35 patients (85.4%); in cases of the presence of a muscular bridge that narrowed the LAD, dissection of this structure was performed in 2 patients (4.9%); left ventricular aneurysm repair surgery in 1 patient (2.4%). In 7 patients (17.1%), the operation was performed on urgent indications. \u0000Results. The average number of grafted arteries was 1.9 ± 0.3 (1 to 4) per patient. There were no mortality. Of the 41 patients with coronary artery lesions with CT, there were 2 cases of acute CAD as a result of their embolism by tumor fragments. Clinical manifestations in these patients differed significantly. \u0000Conclusions. Occurrence of coronary artery embolism in patients with CT according to our data is 0.2% of all patients with CT. CAD accompanies tumor lesions in 4.1% of cases and is diagnosed by angiography and computed tomography. To correct the lesion of the coronary arteries in CT, the full range of surgical techniques is used, including stenting of the coronary artery (spacecraft), coronary artery bypass grafting, removal of the myocardial bridge.","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44771777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-24DOI: 10.30702/ujcvs/22.30(02)/tr029-5966
M. O. Tregubova, K. Rudenko, S. V. Fedkiv, P. Danchenko, Yurii I. Vitkovskyi, M. S. Ishchenko
Background. Hypertrophic cardiomyopathy (HCM) is an autosomal dominant disease with a prevalence of 1 case per 500 people and is the most common cause of sudden cardiac death in young patients. As clinical manifestations and electrocardiographic data are nonspecific and diverse, noninvasive imaging techniques play a key role in the detection of HCM and the understanding of its pathophysiology. The aim. To evaluate the possibilities of ECG-synchronized cardiac multislice computed tomography (MSCT) as a highly informative diagnostic tool for assessing the morpho-functional state of the heart in patients with HCM. Materials and methods. This was a retrospective analysis conducted at the National Amosov Institute of Cardiovascular Surgery from January 2020 to December 2021. We examined 221 cardiac MSCT scans of patients who underwent the examination to assess the spread of myocardial hypertrophy. Particular attention was paid to the presence of crypts at different levels of the left ventricle (LV), anatomical features of the mitral valve and subvalvular apparatus. The presence of systolic pulling of the anterior mitral valve to the interventricular septum, myocardial mass, LV end-diastolic, LV end-systolic volumes and the corresponding indices of body surface area, ejection fraction were determined and calculated during the functional analysis. Additionally, the anatomy and patency of the coronary arte ries were assessed. The studies were performed on a 640-slice Canon Aquilion One CT scanner with retrospective ECG gating and subsequent image processing. The studies were transferred to a workstation for review and evaluation by a team of radiologists. Results. The mean patient age was 46 ± 23 years, 48% were male. Mean maximal LV wall thickness was 19 mm (range 16–34). In 159 patients (71.9%), there was an asymmetric form of HCM with a predominant thickening of the anterior and anteroseptal segments of the left ventricle at the basal and midventricular levels. Fifty-four (24.4%) patients had symmetric form of HCM. The midventricular form of HCM was detected in 4 patients (1.8%). Apical form of HCM was detected in 3 patients (1.3%). One patient was diagnosed with a tumor-like variant of HCM (0.5%). In 198 patients (89.6%), systolic anterior motion of the mitral valve to the interventricular septum was found. In 95 cases (42.9%), morphological abnormality, abnormality of the number or attachment of the papillary muscles were detected. Forty-eight myocardial crypts were detected in 44 patients (21.7%). In 194 patients (87.7%), patent coronary arteries without signs of stenosis were found, 68 patients (30.7%) had 74 myocardial bridges (33.4%). Conclusions. HCM is a genetic heart disease with enormous phenotypic diversity. Due to its high spatial resolution, cardiac MSCT is an accurate diagnostic tool, which allows to assess the morphofunctional state of the LV, mitral valve, subvalvular apparatus, as well as to analyze the anatomy and narrowing of c
背景。肥厚性心肌病(HCM)是一种常染色体显性遗传病，发病率为每500人中有1例，是年轻患者心源性猝死的最常见原因。由于临床表现和心电图资料的非特异性和多样性，无创成像技术在HCM的检测和病理生理学的认识中起着关键作用。的目标。评估心电图同步心脏多层计算机断层扫描(MSCT)作为评估HCM患者心脏形态功能状态的高信息诊断工具的可能性。材料和方法。这是2020年1月至2021年12月在国家阿莫索夫心血管外科研究所进行的回顾性分析。我们检查了221例心脏MSCT扫描的患者，这些患者接受了检查以评估心肌肥厚的扩散。特别注意的是在左心室(LV)的不同水平隐窝的存在，二尖瓣和瓣下装置的解剖特征。在功能分析中，测定并计算二尖瓣前瓣向室间隔的收缩牵拉、心肌质量、左室舒张末期、左室收缩末期容积以及相应的体表面积、射血分数等指标。此外，还评估了冠状动脉的解剖结构和通畅程度。研究是在640层Canon Aquilion One CT扫描仪上进行的，具有回顾性ECG门控和随后的图像处理。这些研究被转移到工作站，由一组放射科医生进行审查和评估。结果。患者平均年龄46±23岁，男性占48%。平均最大左室壁厚为19 mm(范围16-34)。在159例(71.9%)患者中，存在不对称形式的HCM，主要是左心室基底和中水平的前段和前间隔段增厚。对称型HCM 54例(24.4%)。在4例(1.8%)患者中检测到中脑室型HCM。3例(1.3%)患者出现根尖型HCM。1例患者被诊断为肿瘤样HCM变异(0.5%)。198例(89.6%)患者发现二尖瓣向室间隔收缩前移。95例(42.9%)出现形态异常、乳头肌数量异常或附着异常。44例(21.7%)发现48个心肌隐窝。194例(87.7%)无狭窄征象的冠状动脉未闭，68例(30.7%)有74个心肌桥(33.4%)。结论。HCM是一种具有巨大表型多样性的遗传性心脏病。由于其高空间分辨率，心脏MSCT是一种准确的诊断工具，可以评估左室、二尖瓣、瓣下装置的形态功能状态，并分析HCM患者的解剖结构和冠状动脉狭窄。
{"title":"Cardiac Multislice Computed Tomography in the Detection of Phenotypic Polymorphism of Hypertrophic Cardiomyopathy","authors":"M. O. Tregubova, K. Rudenko, S. V. Fedkiv, P. Danchenko, Yurii I. Vitkovskyi, M. S. Ishchenko","doi":"10.30702/ujcvs/22.30(02)/tr029-5966","DOIUrl":"https://doi.org/10.30702/ujcvs/22.30(02)/tr029-5966","url":null,"abstract":"Background. Hypertrophic cardiomyopathy (HCM) is an autosomal dominant disease with a prevalence of 1 case per 500 people and is the most common cause of sudden cardiac death in young patients. As clinical manifestations and electrocardiographic data are nonspecific and diverse, noninvasive imaging techniques play a key role in the detection of HCM and the understanding of its pathophysiology. \u0000The aim. To evaluate the possibilities of ECG-synchronized cardiac multislice computed tomography (MSCT) as a highly informative diagnostic tool for assessing the morpho-functional state of the heart in patients with HCM. \u0000Materials and methods. This was a retrospective analysis conducted at the National Amosov Institute of Cardiovascular Surgery from January 2020 to December 2021. We examined 221 cardiac MSCT scans of patients who underwent the examination to assess the spread of myocardial hypertrophy. Particular attention was paid to the presence of crypts at different levels of the left ventricle (LV), anatomical features of the mitral valve and subvalvular apparatus. The presence of systolic pulling of the anterior mitral valve to the interventricular septum, myocardial mass, LV end-diastolic, LV end-systolic volumes and the corresponding indices of body surface area, ejection fraction were determined and calculated during the functional analysis. Additionally, the anatomy and patency of the coronary arte ries were assessed. The studies were performed on a 640-slice Canon Aquilion One CT scanner with retrospective ECG gating and subsequent image processing. The studies were transferred to a workstation for review and evaluation by a team of radiologists. \u0000Results. The mean patient age was 46 ± 23 years, 48% were male. Mean maximal LV wall thickness was 19 mm (range 16–34). In 159 patients (71.9%), there was an asymmetric form of HCM with a predominant thickening of the anterior and anteroseptal segments of the left ventricle at the basal and midventricular levels. Fifty-four (24.4%) patients had symmetric form of HCM. The midventricular form of HCM was detected in 4 patients (1.8%). Apical form of HCM was detected in 3 patients (1.3%). One patient was diagnosed with a tumor-like variant of HCM (0.5%). In 198 patients (89.6%), systolic anterior motion of the mitral valve to the interventricular septum was found. In 95 cases (42.9%), morphological abnormality, abnormality of the number or attachment of the papillary muscles were detected. Forty-eight myocardial crypts were detected in 44 patients (21.7%). In 194 patients (87.7%), patent coronary arteries without signs of stenosis were found, 68 patients (30.7%) had 74 myocardial bridges (33.4%). \u0000Conclusions. HCM is a genetic heart disease with enormous phenotypic diversity. Due to its high spatial resolution, cardiac MSCT is an accurate diagnostic tool, which allows to assess the morphofunctional state of the LV, mitral valve, subvalvular apparatus, as well as to analyze the anatomy and narrowing of c","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43442091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-24DOI: 10.30702/ujcvs/22.30(02)/shs030-7277
D. Shchehlov, O.Ye. Svyrydiuk, M. Vyval, N. M. Nosenko, F. H. Rzayeva
Carotid near-occlusion (CNO) is the type of severe atherosclerotic stenosis of the internal carotid artery (ICA) with or without collapse of the vessel distally to the narrow part. According to the North American Symptomatic Carotid Endarterectomy Trial (NASCET), severity of ICA stenosis highly correlates with the risk of stroke, except for cases of extremely critical stenosis > 94%, where the risk is lower, and, according to recent guidelines, conservative treatment is preferable. This consideration is questionable due to the recent data about early stroke recurrence and worldwide practice. Rapid improvement of endovascular technique during the last decade makes carotid angioplasty and stenting (CAS) a feasible option for the treatment of patients with CNO and is widely reported in the literature. However, in uncertain circumstances, more scientific data are necessary to fulfill the gap in indications, terms and risks of CAS for CNO. The aim. To evaluate the results of the treatment of patients with CNO after CAS. Materials and methods. Three hundred and fifteen patients were surgically treated at Scientific-Practical Center of Endovascular Neuroradiology of the National Academy of Medical Sciences of Ukraine due to ICA stenosis between 2010 and 2020. Among them, 39 (12.4%) patients (11 woman / 28 men (age 57.9±2.1 years) had CNO and underwent CAS at our Center. Patient population, clinical and radiological investigations, procedure compli-cations were investigated. Procedure complications (stroke, hemodynamic depression [HD] and hyperperfusion syndrome [HPS]) were meticulously studied. All the patients had routine ultrasound and clinical check 30 days after the procedure. Results. All the patients with CNO were successfully stented with the improvement of the site of stenosis after CAS, with only minimal residual stenosis in cases of severe HD. We observed two procedural vascular accidents, first patient had transient ischemic attack (TIA) and one had stroke due to middle cerebral artery occlusion after stent placement and further urgent mechanical thrombectomy. The patient had no neurologic decline and was discharged home. We didn’t observe any cases of myocardial infarction (MI) or death in our series during the hospital stay. HD was seen in 13 (33.3%) patients, and mostly resolved after the procedure except for 3 casesthat required prolonged intensive care unit stay. HPS was diagnosed in 2 (5.1%) patients and also didn’t have anyneurologic consequences after supportive care. During 30 days of follow-up, one (2.6%) patient had TIA because of anti-platelets cessation and 1 (2.6%) patient had MI after 1 week since discharge. All control images revealedstents patency without the evidence of critical residual stenosis. Conclusions. CNO remains important diagnostic and therapeutic challenge. Recent data showed high risk ofrecurrent stroke in case of CNO on best medical therapy, especially at an early stage, but it remains a preferred option ac
{"title":"Angioplasty and Stenting for Carotid Artery Near-Occlusion","authors":"D. Shchehlov, O.Ye. Svyrydiuk, M. Vyval, N. M. Nosenko, F. H. Rzayeva","doi":"10.30702/ujcvs/22.30(02)/shs030-7277","DOIUrl":"https://doi.org/10.30702/ujcvs/22.30(02)/shs030-7277","url":null,"abstract":"Carotid near-occlusion (CNO) is the type of severe atherosclerotic stenosis of the internal carotid artery (ICA) with or without collapse of the vessel distally to the narrow part. According to the North American Symptomatic Carotid Endarterectomy Trial (NASCET), severity of ICA stenosis highly correlates with the risk of stroke, except for cases of extremely critical stenosis > 94%, where the risk is lower, and, according to recent guidelines, conservative treatment is preferable. This consideration is questionable due to the recent data about early stroke recurrence and worldwide practice. Rapid improvement of endovascular technique during the last decade makes carotid angioplasty and stenting (CAS) a feasible option for the treatment of patients with CNO and is widely reported in the literature. However, in uncertain circumstances, more scientific data are necessary to fulfill the gap in indications, terms and risks of CAS for CNO. \u0000The aim. To evaluate the results of the treatment of patients with CNO after CAS. \u0000Materials and methods. Three hundred and fifteen patients were surgically treated at Scientific-Practical Center of Endovascular Neuroradiology of the National Academy of Medical Sciences of Ukraine due to ICA stenosis between 2010 and 2020. Among them, 39 (12.4%) patients (11 woman / 28 men (age 57.9±2.1 years) had CNO and underwent CAS at our Center. Patient population, clinical and radiological investigations, procedure compli-cations were investigated. Procedure complications (stroke, hemodynamic depression [HD] and hyperperfusion syndrome [HPS]) were meticulously studied. All the patients had routine ultrasound and clinical check 30 days after the procedure. \u0000Results. All the patients with CNO were successfully stented with the improvement of the site of stenosis after CAS, with only minimal residual stenosis in cases of severe HD. We observed two procedural vascular accidents, first patient had transient ischemic attack (TIA) and one had stroke due to middle cerebral artery occlusion after stent placement and further urgent mechanical thrombectomy. The patient had no neurologic decline and was discharged home. We didn’t observe any cases of myocardial infarction (MI) or death in our series during the hospital stay. HD was seen in 13 (33.3%) patients, and mostly resolved after the procedure except for 3 casesthat required prolonged intensive care unit stay. HPS was diagnosed in 2 (5.1%) patients and also didn’t have anyneurologic consequences after supportive care. During 30 days of follow-up, one (2.6%) patient had TIA because of anti-platelets cessation and 1 (2.6%) patient had MI after 1 week since discharge. All control images revealedstents patency without the evidence of critical residual stenosis. \u0000Conclusions. CNO remains important diagnostic and therapeutic challenge. Recent data showed high risk ofrecurrent stroke in case of CNO on best medical therapy, especially at an early stage, but it remains a preferred option ac","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42782557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-24DOI: 10.30702/ujcvs/22.30(02)/mr023-2733
O. Marchenko, N. Rudenko, Vladyslav Kavalerchyk
Patients with coronary artery disease (CAD) form a large group among all patients with cardiovascular diseases. Atherosclerosis, as one of the main pathogenetic mechanisms in adverse cardiovascular events development, is one of the leading causes of disability and mortality. Echocardiography is one of the main imaging techniques in managing cardiovascular patients. In search of a new parameter that would reflect both the morphological and functional LV changes, more and more attention has recently been paid to integrated indicators such as the left ventricular global function index (LVGFI) and myocardial contraction fraction (MCF). These parameters are independent predictors of heart failure and cardiovascular diseases. The aim. To evaluate the prognostic value of left ventricular global index and myocardial contraction fraction based on 2D echocardiography results in patients with CAD. Materials and methods. Patients with CAD confirmed by coronary angiography were included in the prospective clinical study. Thirty patients without CAD were a control group, 35 patients had single vessel lesion, 66 had multivessel CAD. LVGFI and MCF were calculated using 2D echocardiography technique. Results. The groups were comparable with respect to age, body mass index (BMI) and comorbidities. The mean age of the patients in group I was 60.53±1.77 years. In group II, the mean age was the highest, 64.31±1.62 years, and in group III the participants were 63.0±1.14 years old. The data indicate the absence of a significant difference (p = 0.39) in the age structure of the patients. In the control group, women predominated (70%), compared to groups II and III, where the proportion of women was 31.2% and 21.2%, respectively (p = 0.0001). The highest BMI classified as obesity class 1 was observed in the first group: 31.74 ± 1.09 kg/m2. Group III had BMI of 30.71 ± 0.62 kg/m2, which also indicates obesity class 1. Group II had the lowest BMI: 29.76 ± 0.77 kg/m2, but the difference between the groups was insignificant (p = 0.432). LVGFI and MCF differed significantly among groups (р=0.003 and р=0.004, respectively). MCF was the highest in patients with multivessel disease – 35.0% (27.71; 42.0), and the lowest in the group with no vascular lesions – 42.29% (36.35; 52.21). LVGFI also was different among the groups. It was the lowest in group III (24.91% [19.22; 30.48]), and the highest in group I (30.85% [25.46; 37.13]). Conclusions. MCF and LVGFI are closely related to the degree of coronary artery involvement. These integral parameters may be used as non-invasive markers of more significant coronary arteries involvement.
{"title":"Left Ventricular Global Function Index and Myocardial Contraction Fraction on 2D Echocardiography as Integral Parameters in Patients with Coronary Artery Disease","authors":"O. Marchenko, N. Rudenko, Vladyslav Kavalerchyk","doi":"10.30702/ujcvs/22.30(02)/mr023-2733","DOIUrl":"https://doi.org/10.30702/ujcvs/22.30(02)/mr023-2733","url":null,"abstract":"Patients with coronary artery disease (CAD) form a large group among all patients with cardiovascular diseases. Atherosclerosis, as one of the main pathogenetic mechanisms in adverse cardiovascular events development, is one of the leading causes of disability and mortality. Echocardiography is one of the main imaging techniques in managing cardiovascular patients. In search of a new parameter that would reflect both the morphological and functional LV changes, more and more attention has recently been paid to integrated indicators such as the left ventricular global function index (LVGFI) and myocardial contraction fraction (MCF). These parameters are independent predictors of heart failure and cardiovascular diseases. \u0000The aim. To evaluate the prognostic value of left ventricular global index and myocardial contraction fraction based on 2D echocardiography results in patients with CAD. \u0000Materials and methods. Patients with CAD confirmed by coronary angiography were included in the prospective clinical study. Thirty patients without CAD were a control group, 35 patients had single vessel lesion, 66 had multivessel CAD. LVGFI and MCF were calculated using 2D echocardiography technique. \u0000Results. The groups were comparable with respect to age, body mass index (BMI) and comorbidities. The mean age of the patients in group I was 60.53±1.77 years. In group II, the mean age was the highest, 64.31±1.62 years, and in group III the participants were 63.0±1.14 years old. The data indicate the absence of a significant difference (p = 0.39) in the age structure of the patients. In the control group, women predominated (70%), compared to groups II and III, where the proportion of women was 31.2% and 21.2%, respectively (p = 0.0001). The highest BMI classified as obesity class 1 was observed in the first group: 31.74 ± 1.09 kg/m2. Group III had BMI of 30.71 ± 0.62 kg/m2, which also indicates obesity class 1. Group II had the lowest BMI: 29.76 ± 0.77 kg/m2, but the difference between the groups was insignificant (p = 0.432). LVGFI and MCF differed significantly among groups (р=0.003 and р=0.004, respectively). MCF was the highest in patients with multivessel disease – 35.0% (27.71; 42.0), and the lowest in the group with no vascular lesions – 42.29% (36.35; 52.21). LVGFI also was different among the groups. It was the lowest in group III (24.91% [19.22; 30.48]), and the highest in group I (30.85% [25.46; 37.13]). \u0000Conclusions. MCF and LVGFI are closely related to the degree of coronary artery involvement. These integral parameters may be used as non-invasive markers of more significant coronary arteries involvement.","PeriodicalId":33680,"journal":{"name":"Ukrayins''kii zhurnal sertsevosudinnoyi khirurgiyi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41473357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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