Indicators of intracardiac hemodynamics in assesment of contractile abilities of myocardium
Abstract
Aim. To assess contractile abilities of the myocardium in patients with non- coronary diseases of the myocardium (NDM) and ischemic heart disease (IHD) according to intracardiac hemodynamics.
Material and methods. The study presents the echocardiographic research of 15 patients with IHD and angina pectoris of II class (all men) and 15 patients with IHD (10 men and 5 women) aged 49,8±1,4 and 33,6±4,2 years respectively.
Method of stress-echocardiography with dobutamine load test was used for differential diagnosis of IHD and NDM. Echocardiography method helped to assess the indicators of intracardiac hemodynamics before and after use of dobutamine. Patients received dobutamine one time in a dosage of 25 mkg/kg/min.
Results. Usage of dobutamine improved indicators of hemodynamics (ESV, LVES), increased ejection fraction from 52% to 61,5%. That confirms the enhance of the overall contractility of the myocardium. Left ventricular contractility index (LVCI) increased from 1,12±0,06 to 1,51±0,07. That shows an increase in the number of segments with contractility disorder. Out of 170 segments with normokinesis 5 segments lost normal contractility and transferred into the state of hypokinesis. From 35 segments with hypokinesis before the load test, 4 has transferred into akinesis. 2 segments out of 20 with akinesis transferred into steady dyskinesis.
In comparison with IHD patients, patients with NDM had improvement of general contractility of myocardium after receiving dobutamine, but in less degree. At the same time, LVCI decreases from 1,29±0,06 to 1,05±0,03, that points to a decrease of segments with disordered contractility. 3 segments out of 8 with steady dyskinesis transferred into akinesis; 2 segments out of 12 with akinesis transferred into hypokinesis; 4 segments out of 61 with hypokinesis transferred into normokinesis.
Conclusion. Multidirectional effect of dobutamine in patients with IHD and NDM can be used in a differential diagnosis of these diseases.
About the Authors
D. K. Vildashin
Tajik Scientific Research Institute of Preventive Medicine
Tajikistan
Tajikistan
Dushanbe
F. I. Odinaev
Department of inner diseases №1, Avicenna Tajik State University
Tajikistan
Tajikistan
M. E. Rajabzoda
Republican Clinical Center for Cardiology
Tajikistan
Tajikistan
Director
Dushanbe
A. I. Tabarov
Republican Clinical Center for Cardiology
Tajikistan
Tajikistan
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Review
For citations:
Vildashin D.K., Odinaev F.I., Rajabzoda M.E., Tabarov A.I. Indicators of intracardiac hemodynamics in assesment of contractile abilities of myocardium. Health care of Tajikistan. 2018;(3):20-27. (In Russ.)
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