Abstract

Background: in patients with congestive heart failure (CHF), there is a change in indicators of heart mechanics against the background of myocardium remodeling. Currently, magnetic resonance imaging (MRI) and speckle tracking echocardiography provide additional options for assessing changes in heart mechanics. Evaluation of mechanics of the myocardium rotational movement according to coronarography (CAG) has not been found in available literature. In this regard, there is a need to develop a methodology that allows to obtain a mathematical description of rotation processes and heartbeat during the CAG.

Material and methods: study included 90 patients aged 30-71 to assess indicators of heart rotation mechanics. Subjects were divided into groups: with dilated cardiomyopathy (DCMP, n=30), left ventricular aneurysm (LVA, n=30) and patients with autonomic nervous system disorder (ANSD, n=30) without heart failure (control group). Mechanics of heart rotation was studied using the CAG technique, modified by us, based on mathematical calculations of the rotation angle in motion of points on the heart surface, determined on the coronary angiogram in two projections.

Results: study found out, that in patients with DCMP and LVA with chronic heart failure, the angle of rotation of the heart was significantly lower than in patients with ANSD who do not have heart disease (p <0,05). The link between impaired myocardial contractile function in patients with DCMP and LVA with chronic heart failure and a decrease in the heart rotation angle was confirmed (DCMP: ?²=9,774; df=1; P <0,05), (LVA: ?²=9,600; df=1; P <0,05).

Conclusion: coronarography technique that we modified, makes it possible to quantify changes in parameters of the heart mechanics in examined patients. This makes it possible to determine the presence or absence of heart failure, depending on results.

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Abstract:

Aim: was to determine what dimensions of an end-diastolic volume (EDV) in patients with reducec left ventricular function (LV) higher chances to measure its value up to 50 ml with Echocardiography compared to MRI.

Materials and methods: the sample consisted of 134 patients with ischemic cardiomyopathy and ejection fraction (EF) less than 35%. A mathematical model that calculates what dimensions of the MLC are more likely to determine its size with an accuracy of up to 50 ml with Echocardiography compared to MRI. Produced logistic regression analysis and calculated odds ratios.

Results: аccording to Echocardiography the EDV was 250.5 ± 67.6 ml, EF was 29.4 ± 5.0 percent. According to MRI, the EDV was 249.3 ± 77.2 ml, EF was 29.9 ± 6.4 percent. Results of the logistic regression analysis showed that EDV to 150 ml have high chances of a consistent measure of EDV with Echocardiography and MRI (OR a 2,5). In groups with EDV more than 150 ml but less than 300 ml had low chances of an accurate measurement of the EDV at the Echocardiography (OR from 0,62 to 0,95). Since EDV is greater than 300 ml, a marked increase chances Echocardiography, to determine EDV up to 50 ml compared to MRI (OR from 2,3 to 4,2).

Conclusions: when EDV to 150 ml, and in dilatation of the left ventricle more than 300 ml MRI has no advantages compared to Echocardiography In these figures there is no need to duplicate echocardiographic study When the EDV of 150 to 300 ml, for determination of volumetric indices it is better to use MRI, because the computations do not depend on the geometric shape of the left ventricle.

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