N. Shybeko, L. Gelis, T. Rusak, Yu. Belinskaya
S o far, surgical interventions with artificial circulation remain the most effective treatment method providing favorable long-term outcomes, prognosis and quality of life in patients with coronary heart disease (CHD). Therefore, the main issue of cardiologists and cardiac surgeons is the prognosis of functional recovery of the left ventricle after revascularization, as the treatment strategy is determined by the risk assessment of surgical mortality and perioperative complications. In order to detect hibernating myocardium, we performed a prospective study including 57 patients with CHD and upcoming coronary bypass grafting, mitral valve plasty or prosthesis. All patients underwent stress magnetic resonance imaging, which allowed noninvasive assessment of both structural and functional changes, as well as determination of myocardial functional reserve. The obtained data will allow us to objectively assess the surgical risk during cardiac surgical interventions, which is very important for the prevention of life-threatening cardiovascular complications, as well as increasing the efficiency of surgical treatment in patients with CHD.
keywords: coronary heart disease, hibernating myocardium, coronary bypass grafting.
for references: N. Shybeko, L. Gelis, T. Rusak, Yu. Belinskaya. Effect of hibernating myocardium on postischemic left ventricular dysfunction after surgical coronary reperfusion. Part 1. Neotlozhnaya kardiologiya i kardiovaskulyarnye riski [Emergency cardiology and cardiovascular risks], 2023, vol. 7, no. 1, pp. 1845–1851.
1. Bokerija, L.A., Gudkova R.G. Itogi nauchnyh issledovanij po probleme serdechno-sosudistoj hirurgii v 2008g [Results of scientific research on the problem of cardiovascular surgery in 2008]. Grudnaja i serdechno-sosudistaja hirurgija, 2009, no. 6, pp. 14-8. (in Russian).
2. Bokerija, L.A., Gudkova R.G. Serdechno-sosudistaja hirurgija – 2014; Bolezni i vrozhdennye anomalii sistemy krovoobrashhenija [Cardiovascular surgery – 2014; Diseases and congenital anomalies of the circulatory system]. Moscow: Nauchnyj centr serdechno-sosudistoj hirurgii RAMN, 2015, 225 p. (in Russian).
3. Booth J., Clayton T., Pepper J., Nugara F., Flather M., Sigwart U., Stables R.H.; SoS Investigators. Randomized, controlled trial of coronary artery bypass surgery versus percutaneous coronary intervention in patients with multivessel coronary artery disease: six-year follow-up from the Stent or Sur gery Trial (SoS). Circulation, 2008, vol. 118, no. 4, pp. 381-388. doi: 10.1161/ CIRCULATIONAHA.107.739144.
4. Ponikowski P., Voors A.A., Anker S.D., Bueno H., Cleland J.G.F., Coats A.J.S., Falk V., González-Juanatey J.R., Harjola V.P., Jankowska E.A., Jessup M., Linde C., Nihoyannopoulos P., Parissis J.T., Pieske B., Riley J.P., Rosano G.M.C., Ruilope L.M,. Ruschitzka F., Rutten F.H., van der Meer P.; ESC Scientific Document Group. 2016 ESC Guide - lines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Eur Heart J, 2016, vol. 37, no. 27, pp. 2129-2200. doi: 10.1093/eurheartj/ehw128.
5. Shumovec V.V., Shket A.P., Grinchuk I.I., Uss N.L., Sevruk T.V., Ostrovskij Ju.P. Rol’ narushenij lokal’noj sokratimosti miokarda levogo zheludochka u pacientov s umerennoj ishemicheskoj mitral’noj nedostatochnostju [The role of disorders of local contractility of the myocardium of the left ventricle in patients with moderate ischemic mitral insufficiency]. Kardiologija v Belarusi, 2017, vol. 9, no. 6, pp. 1127-1116. (in Russian).
6. Bokerija L.A., Aslanidi I.P., Shurupova I.V., Muhortova O.V, Derevjanko E.P., Merzljakov V.Ju., Kljuchnikov I.V., Goluhova E.Z., Nikitina T.G. Gibernirovannyj miokard kak faktor prognoza blizhajshih rezul’tatov koronarnogo shuntirovanija u bol’nyh s ishemicheskoj disfunkciej levogo zheludochka [Hibernated myocardium as a prognostic factor for immediate results of coronary artery bypass grafting in patients with ischemic dysfunction of left ventricle]. Klinicheskaja fiziologija krovoobrash - henija, 2011, no. 1, pp. 31-39. (in Russian).
7. Tang W.H., Francis G.S. The Year in Heart Failure. J Am Coll Cardiol, 2007, vol. 50, no. 24, pp. 2344-2351. doi: 10.1016/j.jacc.2007.09.015.
8. Kramer C.M., Barkhausen J., Flamm S.D., Kim R.J., Nagel E. Standardized cardiovascular magnetic resonance (CMR) protocols 2013 update. J Cardiovasc Magn Reson, 2013, vol. 15, no. 1, pp. 91-101. doi: 10.1186/1532-429X-15-91.
9. Shibeko N.A., Gelis L.G., Rusak T.V. Diagnosticheskie priznaki reperfuzionnogo povrezhdenija miokarda pri koronarnom shuntirovanii [Diagnostic signs of myocardial reperfusion injury after coronary artery bypass grafting]. Neotlozhnaja kardiologija i kardiovaskuljarnye riski, 2021, vol. 5, no. 1, pp. 1167-1171. doi: 10.51922/2616633X.2021.5.2.1167. (in Russian).
10. Rusak T.V., Gelis L.G., Medvedeva E.A., Shibeko N.A. MRT-diagnostika ishemicheskogo i reperfuzionnogo povrezhdenija miokarda u lic s ostrym koronarnym sindromom [MRI-diagnostics of myocardial ischemic and reperfusion injury in patients with acute coronary syndrome]. Kardiologija v Belarusi, 2020, vol. 12, no. 1, pp. 6-21. doi: 10.34883/PI.2020.12.1.001. (in Russian).
