Abstract: Revascularization strategy definition in acute coronary syndrome in patients with multivessel coronary artery disease is a significant problem of modern intervention cardiology Aim: was to evaluate effectiveness of special PC programs «Sapphire 2015 - Right dominance» and «Sapphire 2015 - Left dominance» designed to the revascularization strategy definition ir acute coronary syndrome patients. Materials and methods: revascularization strategy of 50 acute coronary syndrome patients was analyzed. In all cases the revascularization strategy was defined by the group of intervention cardiologists with the help of independent experts and special PC programs «Sapphire 2015 - Right dominance» and «Sapphire 2015 - Left dominance». Experts-, physicians-, and soft- based revascularization strategies were compared among themselves. Results: complete coincidence between expert-based and soft-based revascularization strategies was registered in 66% patients and the incomplete coincidence - in 32% patients. Complete mismatch between expert-based and soft-based revascularization strategies was registered in 2% patients. The complete coincidence between physicians-based and soft-based revascularization strategies was registered in 42% patients and the incomplete coincidence - ir 52% patients. Complete mismatch between physicians-based and soft-based revascularization strategies was registered in 6% patients Conclusion: as well as experts, special PC programs «Sapphire 2015 - Right dominance» and «Sapphire 2015 - Left dominance» provide success in the revascularization strategy definition 1г acute coronary syndrome patients with multivessel coronary artery disease. References 1. Hsieh V., Mehta S.R. How should we treat multi-vessel disease in STEMI patients? Curr. Treat. Options. Cardiovasc. Med. 2013; 15(1): 129-136. 2. Sardella G., Lucisano L., Garbo R. et al. Singlestaged compared with multi-staged PCI in multivessel NSTEMI patients: The SMILE Trial. J. Am. Coll. Cardiol. 2016; 67(3): 264-272. 3. Ayalon N., Jacobs A.K. Incomplete revascularization in patients treated with percutaneous coronary intervention. When enough is enough. J. Am. Coll. Cardiol. Intv. 2016; 9(3): 216-218. 4. Iqbal M.B., Ilsley C., Kabir T. et al. Culprit vessel versus multivessel intervention at the time of primary percutaneous coronary intervention in patients with ST-segment-elevation myocardial infarction and multivessel disease: real-world analysis of 3984 patients in London. Circ. Cardiovasc. Qual. Outcomes. 2014; 7: 936-943. 5. Kornowski R., Mehran R., Dangas G. et al. Prognostic impact of staged versus «one-time» multivessel percutaneous intervention in acute myocardial infarction: analysis from the HORIZONS-AMI (harmonizing outcomes with revascularization and stents in acute myocardial infarction) trial. J. Am. Coll. Cardiol. 2011; 58: 704-711. 6. Tarasov R.S., Ganyukov V.I., Shilov A.A. i dr. Prognosticheskaya znachimost shkaly SYNTAX v ocenke iskhodov i vybora taktiki revaskulyarizacii u pacientov s infarktom miokarda i podemom segmenta ST pri mnogososudistom porazhenii koronarnogo rusla. [Prognostic impact of the SYNTAX scale in the evaluation of outcomes and choice of revascularization tactic in patients with myocardial infarction and ST-segment elevation with multi-vessel coronary artery disease]. Terapevtichesky arhiv. 2012; 84 (9): 17-21 [In Russ]. 7. Petrosyan Yu.S., Ioseliani D.G. O summarnoy ocenke sostoyaniya koronarnogo rusla u bolnyh ishemicheskoy boleznyu serdca. [About cumulative assessment of coronary arteries disease in patients with myocardial ischemia]. Mezhdunarodny zhurnal intervencionnoy kardioangiologii. 2013; 37: 49-55 [In Russ]. 8. Petrov V.I., Nedogoda S.V. Medicina, osnovannaya na dokazatelstvah: uchebnoe posobie. [Medicine-based evidence: a tutorial]. 9. Kaul P., Ezekowitz J.A., Armstrong P.W. et al. Incidence of heart failure and mortality after acute coronary syndromes. Am. Heart J. 2013; 165(3): 379-385. 10. El-Hayek G.E., Gershlick A.H., Hong M.K. et al. Metaanalysis of randomized controlled trials comparing multivessel versus culprit-only revascularization for patients with ST-segment elevation myocardial infarction and multivessel disease undergoing primary percutaneous coronary intervention. Am. J. Cardiol. 2015; 115(11): 1481-1486. 11. Antman E.M., Anbe D.T., Armstrong P.W. et al. ACC/AHA Guidelines for the management of patients with ST-Elevation myocardial infarction-executive summary. A report of the American College of Cardiology / American Heart Association task force on practice guidelines (Writing Committee to revise the 1999 Guidelines for the management of patients with acute myocardial infarction). Circ. 2004; 110: 588-636. 12. Windecker S., Kolh P., Alfonso F. et al. 2014 ESC/EACTS Guidelines on myocardial revascularization. The task force on myocardial revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur. Heart J. 2014; 35: 2541-2619. 13. Bainey K.R., Mehta S.R., Lai T. et al. Complete versus culprit only revascularization for patients with multivessel disease undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: a systematic review and meta-analysis. Am. Heart J. 2014; 167: 1-14.
Abstract: Aim: was to assess dynamics of strain (S) and strain rate (SR) of longitudinal, circular and radial fibers in patients with left ventricular (LV) aneurysm (LVA) before and in early stages after coronary artery bypass graft (CABG) using Velocity Vector Imaging. Material and methods: in 270 segments LV in patients with LVA, S and SR of LV fibers was analyzed before and after CAB. Also analysis of S and SR was performed in patients with CABG and plastic of the LV (group 1, 144 segments) and in the group with CABG without plastic of the LV (group 2, 126 segments). Results: a function of longitudinal, circular and radial fibers after CABG has improved in all patients. Only SR of radial fibers reached normal. In group 1 was received the positive dynamics from the longitudinal S and SR, and SR circular and radial fibers. In group 2 indicators of function of longitudinal and circular fibers remained without negative dynamics, but positive dynamics is observed only from the SR of the radial fibers. The SR of radial fibers in both groups was normalized. Conclusion: improvement of LV function in all patients is due to the group I. It is important to study the LV function in patients with LVA depending on the type of surgery. References 1. Paramonova T.I., Basylev V.V., Vdovkin A.V., Palkova V.A., Karpuchin V.G. Vliyanie operacij rekonstrukcii levogo zheludochka na funkcional'nye i ob"emnye pokazateli u bol'nyh s postinfarktnoj anevrizmoj. [The impact of operations on the reconstruction of the left ventricle function and volume indices in patients with postinfarction aneurism.] Diagnostic radiology and radiotherapy. 2015; 1(6): 74-81 [In Russ]. 2. Dor V., Di Donato M., Civaya F. Postinfarktnoe remodelirovanie levogo zheludochka: magnitno-rezonansnaya tomografiya dlya ocenki patofiziologii posle rekonstrukcii levogo zheludochka. [Post myocardial infarct remodeling: role of magnetic resonance imaging for the assessment of its pathophysiology after left ventricular reconstruction.] Thoracic and Cardiovascular Surgery. 2014; 3: 14-27 [In Russ]. 3. Chernyavskii A.M., Kareva Yu. E., Denisova M.A.,Efendiev V.U. Problema predoperacionnogo modelirovaniya levogo zheludochka. [The problem of preoperative left ventricular modeling.] Cardiology and Cardiovascular Surgery. 2015; 2: 4-7 [In Russ]. 4. Carasso Sh., Biaggi P., Rakowski H. et al. Velocity Vector Imaging: Standart Tissue - Tracking Results Acquired in Normals - The VVI - Strain Study. Journal of the American Society of Echocardiography. 2012; 25(5): 543-552. 5. Alekhin M.N. Ul'trazvukovye metody ocenki deformacii miokarda i ih klinicheskoe znachenie. [Ultrasound estimation techniques and their clinical significance.] M.: Vidar-M, 2012; 88 p [In Russ]. 6. Rostamzadeh A., Shojaeifard M., Rezaei Y, et al. Diagnostic accuracy of myocardial deformation indices for detecting high risk coronary artery disease in patient without regional wall motion abnormality. Int J Clin Exp Med. 2015; 8(6): 9412-9420. 7. Pavlyukova E.N., Karpov R.S Deformaciya, rotaciya i povorot po osi levogo zheludochka u bol'nyh ishemicheskoj bolezn'yu serdca s tyazheloj levozheludochkovoj disfunkciej. [Deformation, rotation, and axial torsion of the left ventricle in coronary heart disease patients with its severe dysfunction. ] Terapevticeskij arhiv. 2012;9: 11-16 [In Russ]. 8. Lang R.M., Badano L.P, Mor-Avi V., et al. Recommendation for cardiac chamber quantification by echocardiography in adults: an update from the American society of echocardiography and the European association of cardiovascular imaging. 2015; 16: 233-271. 9.
