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Aim: was to evaluate the prognostic effectiveness of the method of cardiac magnetic resonance imaging (MRI) in patients with ischemic heart disease (IHD) with dysfunctional myocardium after endovascular interventions

Materials and methods: a total of 114 patients were included in the study Inclusion criteria: myocardial infarction in previously; myocardial ischemia according to stress tests; occlusion or subtotal stenosis of one or more coronary arteries according to digital angiography (SYNTAX score <32); viable myocardium in the zone of the occluded/stenotic artery; heart failure of I-III functional class (NYHA); left ventricular ejection fraction (LVEF) less than 50%. Patients were randomized into 2 equivalent groups: in the I group, myocardial viability was determined by cardiac magnetic resonance imaging (MRI) with delayed contrast, in the II group - by stress-echocardiography with dobutamine. All patients underwent stenting of coronary arteries in the zone of the viable myocardium with drug-eluting stents. Long-term results of treatment were followed to 12 months after endovascular intervention in all patients.

Results: all patients had a significant improvement in the local contractility of the myocardium after performed endovascular myocardial revascularization. After 12 months, a significant decrease in the mass fraction of ischemic viable myocardium in the peri-infarction zone was noted among patients from group I, compared with preoperative data (32.8 ± 2.4 and 24,3±2,3%, respectively, p<0.05). Thus, in I group the volume of ischemic myocardium decreased by 26%. In all studied groups, there was a significant increase in LVEF, compared with data obtained when the patient was discharged from the hospital. Survival in the I group was 100%, whereas in the II group - 97.3% (p> 0.05). The incidence of non-fatal MI was 0.88 and 3.5% in groups I and II, respectively (p <0.05).

Conclusion: cardiac MRI with delayed contrast is more effective and sensitive for diagnosis of myocardial viability and patient prognosis after endovascular intervention, compared with stress echocardiography with dobutamine. 



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