Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Ischemic left ventricular remodeling in anomalous origin of the left coronary artery from the pulmonary trunk

Authors: T.V. Rogova, L.A. Boсkeria, I.P. Aslanidis

Company:
A.N. Bakoulev Scientific Center for Cardiovascular Surgery of Russian Academy of Medical Sciences, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

Link: Clinical Physiology of Blood Circulaiton. 2013; (): -

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Abstract

Objective. Study of the causes and extent of ischemic left ventricular remodeling in the anomalous discharge of the left coronary artery in different types of the disease, its effect on the severity of heart failure and results of surgical treatment.

Material and methods. We examined 111 patients with ALCAPA. The age groups considered: I < 1 year; II – between 1 and 3 years; III > 3 years. Echocardiography, ECG studies performed in all patients, Holter monitoring conducted 26 patients (21 patients I group), angiographic study of 92 patients (I group – 39 patients, II – 13 patients, III – 40 patients), radionuclide diagnostics methods – 60 patients (I group – 37 patients, III – 23). Statistical data processing was performed with the use of programs such as Microsoft Excel 2000 and Statistica 6.0 (Stat-Soft, 2001).

Results. According to the data of clinical and instrumental examination, the highest degree of ischemic LV remodeling was defined in the first age group. Weak intercoronary collateral vessels determines the large myocardial ischemic injury of LV (25.24±10.34%), which determines the severity of LV remodeling LVDI > 200 ml/m2, sharp decrease in contractility, increase of dysfunctional segments number. The large size of the left ventricle into the became a risk factor for congestive heart failure, arrhythmias, cardio shock. Patients with increase of LVDI > 150 ml/m2, EF < 35% constituted the group of the high surgical risk.

Conclusions. A large part of the affected myocardium ischemia is in a state of hibernation and could recover after reperfusion. This makes to look for methods of pre-, intra- and postoperative treatment, which could be an alternative to heart transplantation.

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