Abstract: The aim of the study was to evaluate results of percutaneous coronary interventions (PCI) in patients with ischemic cardiomyopathy (ICMP) - potential candidates for heart transplantation. The study included 37 patients with ICMP. All the patients before PCI and within the 7 days after it undergo ec-hocardiography and ECG-gated SPECT. The amount of irreversibly damaged myocardium of the left ventricle (LV) was about 50 % of its volume. In these patients ECG-gated SPECT did not show sufficient amount of the viable myocardium, capable to restore the heart function after revascularization. The main result of intervention was increase in survival rate of patients with ICMP within 4 years of observation in comparison with traditional methods of conservative therapy. The first clinical effect of PCI was disappearance or reduction of dyspnea, noted in the majority of the patients. These changes had been confirmed by improvement of a functional class of patients (NYHA class score increase to 3,2±0,5 from 1,7+65; p=0,007) and increase of tolerance to physical excersise. Positive changes of a clinical condition after PCI have taken place due to decrease in rigidity of LV myocardium: It became apparent due to decrease of LV end-diastolic pressure (35,7+9,3 vs. 23,5+9,9 Hg mm; p=0,04) and pressure in pulmonary artery (44+1 2 vs. 33+7 Hg mm; p=0,03). No changes of LV volumes and ejection fraction values in the given category of patients were seen.
Reference
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Abstract: MRI in aortic coarctation pre-operative assessment is safe, prompt, non-invasive and can be used instead of conventional angiography. Synchronization of MRI data acquisition to the cardiac cycle eliminates breathing and motion artifacts, and allows non-contrast enhanced imaging. The latter is essential in pediatric practice. References 1. Никитаев Н.С., Кармазановский Г.Г., Черняк Б.Б. Коарктация аорты – возможности спиральной КТ. Мед. визуализация. 2001; 1:54-61. 2. Королев Б.А., Охтин И.К., Соловьев С.И. и др. Хирургическое лечение коарктации аорты у взрослых больных. Хирургия. 1983; 2: 3-6. 3. Julsrud P.R. et al. Coarctation of the aorta. Collateral flow assessment with phase-contrast MR angiography. A.J.R. 1997; 169: 1735-1742. 4. Березов Ю.И., Покровский А.В., Мельник И.З. Коарктации аорты атипичной локализации. Грудная хирургия. 1964; 5: 51-57. 5. Евдокимов А.Г., Тополянский В.Д. Болезни артерий и вен. М.: Высшая школа. 1999; 103-139. 6. Sans S., Kestcloot H. Task Force of the Europe an Society of Cardiology on cardiovascular mortality and morbidly statistics. Eur. Heart. J. 1997; 1231-1248. 7. Erbel R. et al. Detection of dissection of the aortic intima and media after angioplasty of coarctation of the aorta. An angiographic, computertomographic and echocardiographic comparative study. Circulation. 1990; 81: 805-814. 8. Glasow P.F. et. al. Surgery without angiography for neonates with aortic arch obstruction. Int.J. Cardiol. 1988; 18 (3): 417-425. 9. Marchal G., Bogarert J. Non invasive imaging of great vessels of the chest. Eur. Radiol. 1998; 8 (7): 1099-1105. 10. Синицин В.Е., Дадвани С.А., Артюхина Е.Г. и др. Компьютерная томографическая ангиография в диагностике атеросклеротических поражений аорты и артерий нижних конечностей. Ангиология и сосудистая хирургия. 2000; 6:37-44. 11. Синицин В.Е., Дадвани С.А., Мершина Е.А. и др. Магнитно-резонансная ангиография в диагностике и хирургическом лечении заболеваний брюшной аорты и артерий нижних конечностей. Ангиология и сосудистая хирургия. 2001; 7: 23-33.
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