Left and right ventricular diastolic dysfunction in patients with coronary heart disease and initial stages of chronic heart failure

Abstract

Aim. To study left and right ventricular (LV, RV) diastolic dysfunction in patients with coronary heart disease (CHD) and initial stages of chronic heart failure (CHF). Material and methods. In total, 64 patients with CHD and NYHA Functional Class (FC) I-II CHF (31 men, 33 women; mean age 58,9±2 years) underwent LV and RV myocardial contractility assessment, by balanced radioven-triculography (BRVG), with segmental histogram analysis. Control group included 19 relatively healthy individuals aged 17-48 years. Results. LV and RV ejection fraction was normal in all participants: 63,6+4,6% and 53,4±5,2%, respectively. At the same time, diastolic dysfunction - decreased peak filling velocity - was registered: 259±25%/s and 194±22%/s, as well as decreased 1/3 diastolic filling: 25,9±4,9%/s and 18,3±3,2%/s, respectively. Local dyskinesia was registered for both LVandRV. In LV, 321 segments (62,9%) were normokinetic, 163 (31,8%) - hypokinetic, and 28 (5,4%) - akinetic. Normokinetic zones localized in intraventricular septum (IVS), posterior or lateral LV walls (91%), hypokinetic (85,8%) and akinetic zones (85,7%) - in superior IVS and anterior wall. InRV, prevalence of hypo- or akinetic zones reached 43,5%. Akinetic (70%) and hypokinetic (49%) zones were situated in free RVwall, normokinetic segments (84%) - in anterior-septal RVarea. Conclusion. In CHD patients with initial stages of CHF, LV and RV diastolic dysfunction was observed, manifesting in LV and RV local dysfunction. Maximal segmental contractility abnormalities were registered in LV anterior-septal area and RV free wall.

Keywords

• coronary heart disease
• initial stages of chronic heart failure
• local contractility
• balanced biventricular radioventriculography