Abstract
Introduction. Ischemic mitral regurgitation (IMR) is a frequent complication in patients with myocardial infarction significantly determining the development of severe heart failure and limiting the survival. Peculiarities of left atrium (LA) remodeling in patients with moderate IMR are understudied.
Research objective: evaluation of LA function in patients with moderate IMR before and after CABG and mitral annuloplasty.
Material and methods. The study involved 50 patients with coronary artery disease after myocardial infarction, with moderate IMR (28±6% to LA area) who needs surgical revascularization. Comparable in age and sex comparative group included 30 apparently healthy persons. Besides conventional echocardiography
(EchoCG) the functional, geometric and mechanical parameters of LA activity were studied. Patients underwent
CABG (4±1.3 distal anastomosis) and mitral annuloplasty. EchoCG data were re-evaluated one year
after surgery.
Results. It is revealed that even at moderate degree of IMR a significant inhibition of functional and mechanical
parameters of LA activity happen. There is no significant reversion of geometric, functional and
mechanical characteristics of LA at one year of follow-up, which is probably related to the irreversible
changes in atrium, developed on the background of its volume overload. It is found that with initial factors
of mechanical dysfunction of LA in IMR patients a post surgery decrease of functional data is associated.
Predictors of negative dynamics for expansion index, fraction of passive and active emptying are indicators
of strain in the reservoir phase ≤ 23% and strain rate ≤ 0,28 s–1 in the reservoir period, strain rate in the conduit
period ≥–0.46 s–1, pumping strain ≥–3% and strain rate in the pumping phase ≥–1,1 s–1.
Conclusion. Detected values are markers of mechanical dysfunction of left atrium after CABG and mitral
annuloplasty.
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About the authors
- Синельников Юрий Семенович, доктор мед. наук, и.о. гл. врача ФГБУ «ФЦССХ им. С.Г. Суханова» (г. Пермь);
- Орехова Екатерина Николаевна, доктор мед. наук, зав. отделением;
- Матановская Татьяна Владимировна, врач отделения функциональной диагностики;
- Шарлаимов Станислав Александрович, врач
