PREVENTION OF LEFT VENTRICLE SYSTOLIC DYSFUNCTION IN PATIENTS WITH ACUTE CORONARY SYNDROME WITH ST SEGMENT ELEVATION AFTER CARDIAC REVASCULARIZATION

Aim. To study effects of bioflavonoid quercetin (corvitin) on left ventricle (LV) systolic dysfunction in patients with acute coronary syndrome with ST segment elevation (ACS+ST) after cardiac revascularization.Material and methods. 60 patients with ACS+ST (44,2±1,3 y.o.) were examined. Patients were admitted to hospital within 6 hours after complaints beginning. Patients were randomized in two groups. 30 patients of group A had standard therapy and cardiac revascularization. 30 patients of group B received corvitin additionally to standard therapy before cardiac revascularization. Echocardiography initially and stress-echocardiography with dobutamine after status stabilization (at 8-10 days of disease) were performed.Results. Dobutamine test (with low and high doses) showed myocardial viability in patients of group B. Patients of group A had irreversible LV systolic dysfunction in 32 % of segments. Corvitin slowed down LV dilatation progression in patients with ACS+ST. It resulted in the end-diastolic and end-systolic indexes did not change within 10 days. The LV ejection fraction was more increased in patients of group B in comparison with patients of group A.Conclusion. The early corvitin prescribing has positive effects on LV systolic function and prevents post-reperfusion complications. </p

Left ventricular remodelling in patients with reversible ischemic dysfunction before and after myocardial revascularization

Aim. To study the dynamics of left ventricular (LV) remodelling in patients with myocardial infarction (MI) and reversible ischemic dysfunction, before and after myocardial revascularization. Material and methods. The study included 69 patients after MI. All participants underwent two-dimensional echocardiography (EchoCG), within 24 hours after hospital admission and one month after revascularization. After three-four days of treatment and clinical stabilization, the patients underwent stress EchoCG with dobutamine, to assess myocardial viability. Results. Complete or partial recovery of all asynergic myocardial segments was observed in 22 (Group I) and 19 (Group II) patients, respectively, while in 28 (Group III), LV aneurysm was detected. In most patients from each group, transluminal balloon angioplasty (TLBAP) with stent implantation was performed. The proportion of conservatively treated patients was maximal in Group III. Despite revascularization, in coronary patients with impaired myocardial viability (Group III), the increase in ejection fraction and reduction in end-systolic volume was significantly lower than in patients with viable myocardium. Sphericity index, relative wall thickness index, and myocardial stress parameters were increased in each group, although this increase was non-significant in Group III. After revascularization, a significant reduction in end-systolic volume, and a tendency towards enddiastolic LV volume reduction were observed in each group, being maximal in Group I. Conclusion. In MI patients with viable myocardium in dyskineticLV zones, revascularization surgery should be considered