Российский кардиологический журнал (May 2014)
CONTEMPORARY METHODS FOR MYOCARDIAL FUNCTION EVALUATION IN PATIENTS WITH HYPERTROPHIC CARDIOMYOPATHY BEFORE AND AFTER SURGICAL TREATMENT
Abstract
Aim. To invent and qualify a diagnostic algorhythm for systolic and diastolic myocardium function evaluation in the left ventricle in patients with hypertrophic cardiomyopathy before and after surgical treatment.Material and methods. Totally 88 patients included, 54 with hypertrophic cardiomyopathy (27 male, 27 female) with median age 59±13 y.o. Obstructive type of HCMP was found in 41 pt. Transluminal ethanol-based septal ablation was done for 17 pts. Myoectomy/myotomy was done for 11 pts. The control consisted of 34 healthy volunteers with medial age 36,7±8,3 y.o.: 24 men (70%) and 10 women (30%). To everyone included the echocardiography was performed using the Vivid E9 machine (GE, USA) with multifrequent sensor 3,5-5,0 MHz. The data was then processed by computer-based Multivox program. The "flow-volume" loop of the single cardiac cycle was reconstructed using numeric data for everyone of patients; also the data on myocardium segment shift were used.Results. The parameters of volume change rapidity (dVol/dt (s, d)) and the parameters of systolic and diastolic summes of normal velocities (I Vr (s, d)) serve as strict independent predictors of the impaired systolic and diastolic function of LV myocardium and also as early markers of LV disordered function recovery in HCMP after surgical treatment. The markers of long axis diastolic shift (dL/dt (d)) and diastolic volume changes (dVol/dt (d)) are the most accurate in prediction of left ventricle changes after surgical treatment in HCMPConclusion. We have invented a novel and original approach to the evaluation of systolic and diastolic myocardial function in patients with obstructive type hypertrophic cardiomyopathy before and after surgical treatment using our own algorhythm based on echocardiographical measurements of myocardium shift rapidity.
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