Clinical Physiology of Circulation

ISSN 1814-6910 (Print)
ISSN 2410-9134 (Online)

 

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


Issue's catalogue ➤ КФК. 2022; 19 (3): 193-286 ➤ Эхокардиографические показатели, сопряженные с риском повреждения миокарда при выполнении каротидной эндартерэктомии

Myocardial bridges: optimization of diagnostic approaches. Role of multispiral computed tomography

Authors: Boсkeria L.A., Makarenko V.N., Kurbanova B.G.

Company:
Samara State Medical University, Ministry of Health of the Russian Federation, Samara, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2022-19-3-231-237

UDC: 616.132.2-089

Link: Clinical Physiology of Blood Circulaiton. 2022; 3 (19): 231-237

Quote as: Tereshina O.V. Echocardiographic parameters associated with the risk of myocardial damage during carotid endarterectomy. Clinical Physiology of Circulation. 2022; 19 (3): 231–7 (in Russ.). DOI: 10.24022/1814-6910-2022-19-3-231-237

Keywords:  perioperative myocardial damage echocardiography troponin carotid endarterectomy left ventricular remodeling

Received / Accepted:  06.09.2022 / 26.09.2022

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Abstract

Рутинное определение тропонина после внекардиальных операций выявило широкое распространение бессимптомного периоперационного повреждения миокарда (ППМ). Известно, что ППМ сопровождается увеличением поздней летальности. Причины развития ППМ до конца не определены.

Routine determination of troponin after extracardiac surgeries has revealed a wide spread of asymptomatic perioperative myocardial damage (PPM). PPM is known to be accompanied by increased late mortality. The causes of PPM development have not been fully determined.

Objective. To determine which echocardiographic characteristics of cardiac remodeling are significantly associated with the risk of perioperative myocardial damage during carotid endarterectomy.

Material and methods. 69 patients with combined coronary and precerebral artery lesions underwent CEAE were included in the study. The patients underwent a complete cardiological examination. The cTn-I level was taken as the fact of PPM development. It was determined on admission and the first day after the operation. Postoperative cTn-I values above the 99th percentile of the URL without evidence of myocardial ischemia were treated as PPM. The study endpoints were: PPM, perioperative MI and stroke, mortality from MI and stroke. Statistical analysis was performed by calculating nonparametric measures of descriptive statistics and performing logistic regression analysis.

Results. There were no lethality, stroke, or myocardial infarctions after CEAE. Perioperative increase in cTn-I level over the normal range in 21 (30%) patients. All patients with an increase in the level of cTn-I were asymptomatic, none of these patients had evidence of myocardial ischemia. The end-diastolic LV size (AUC 0.82, p = 0.001, Se 100%, Sp 88%), the endsystolic LV size (AUC 0.701 p = 0.008, Se 100%, Sp 57%), the end-systolic left ventricular volume (AUC 0.768 p < 0.001, Se 1 00%, Sp 56%) were highly sensitive and specific indicators of PPM development.

Conclusion. The most significant risk factor for the development of PPM during carotid endarterectomy in patients with coronary heart disease was left ventricular remodeling characterized by dilation of the left heart chamber.

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****
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About Authors

Ol’ga V. Tereshina, Cand. Med. Sci., Associate Professor, Head of functional diagnostic department; ORCID

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