scholarly journals A patient with abnormalities of the coronary arteries and non-compaction of the left ventricular myocardium resulting in ischaemic heart disease symptoms

2015 ◽  
Vol 74 (4) ◽  
pp. 518-523 ◽  
Author(s):  
J. Dąbek ◽  
M. Majewski ◽  
W. Walkowicz ◽  
Z. Gąsior
Author(s):  
Wojciech Tański ◽  
Paweł Gać ◽  
Angelika Chachaj ◽  
Małgorzata Sobieszczańska ◽  
Rafał Poręba ◽  
...  

Abstract Background The aim of the study was to assess the relationship between the occurrence of rheumatoid arthritis (RA) and ankylosing spondylitis (AS) and the cardiac magnetic resonance (CMR) changes in people without clinically overt heart disease. Methods The study group consisted of 74 people (48.81 ± 11.35 years): 29 patients with RA, 23 patients with AS and 22 people from control group. Blood samples were taken to assess laboratory parameters, disease activity was determined using activity scales, and CMR was performed. Results It was shown that the factors independently related to higher left ventricular mass index are AS occurrence, human B27 leukocyte antigen occurrence, higher neutrophil gelatinase–associated lipocalin concentration (NGAL) and higher body mass index (BMI). The lower right ventricular ejection fraction is result of an independent effect of RA, AS and higher NGAL. RA presence, methotrexate use, higher rheumatoid factor titer, higher NGAL, older age and higher BMI should be considered independent risk factors for greater left ventricular myocardium water content. RA occurrence, AS occurrence, type 2 diabetes occurrence and a higher C-reactive protein concentration can be independently associated with a higher probability of non-ischemic left ventricular myocardium injury. Larger pericardial fluid volume is result of an independent effect of higher NGAL, higher anti-cyclic citrullinated peptide antibodies titer and higher DAS28 disease activity index. Use of steroids is protective factor against larger volume of pericardial fluid. Conclusions RA and AS in people without clinically apparent heart disease are associated with the occurrence of adverse changes in CMR. Key Points•RA and AS in people without clinically apparent heart disease are associated with the occurrence of adverse changes in CMR..•The independent risk factors for higher LVEF are AS occurrence, human B27 leukocyte antigen occurrence, higher NGAL concentration and higher BMI..•RA presence, methotrexate use, higher RF, higher NGAL, older age and higher BMI are independent risk factors for higher LV T2 ratio..•RA occurrence, AS occurrence, type 2 diabetes occurrence and a higher CRP are independently associated with a higher risk of non-ischemic LV myocardium injury..


Kardiologiia ◽  
2015 ◽  
Vol 4_2015 ◽  
pp. 5-13
Author(s):  
A.M. Chernyavsky Chernyavsky ◽  
O.S. Efanova Efanova ◽  
V.U. Efendiyev Efendiyev ◽  
D.A. Sirota Sirota ◽  
E.M. Alyapkina Alyapkina ◽  
...  

2014 ◽  
Vol 61 (1.2) ◽  
pp. 53-58 ◽  
Author(s):  
Hayato Nose ◽  
Hideki Otsuka ◽  
Yoichi Otomi ◽  
Kaori Terazawa ◽  
Shoichiro Takao ◽  
...  

2021 ◽  
Vol 25 (4) ◽  
pp. 589-592
Author(s):  
V. Yu. Maslovsky

Annotation. In Ukraine, one of the most pressing medical and social problems is coronary heart disease, in particular, such a form as myocardial infarction. Also, as in most countries, coronary heart disease plays a leading role in morbidity and mortality. In Ukraine, coronary heart disease accounts for 65% of the mortality from diseases of the circulatory system of the working population and is the main cause of disability. The aim of the work is to determine the features of the structural and functional state of the myocardium in patients with myocardial infarction without ST segment elevation depending on the nature of the anatomical lesion of the coronary arteries. We conducted a comprehensive study of 200 patients with acute myocardial infarction without ST-segment elevation (NSTEMI) aged 38 to 80 years. According to coronary angiography, the degree of damage to the coronary arteries was determined, and according to echocardiography – the structural and functional state of the myocardium. Comparison of percentages between groups was performed by the criterion χ2, absolute values – by Mann-Whitney U test. The structural condition of the left ventricular myocardium in NSTEMI patients deteriorated significantly. The total severity of coronary artery disease, calculated from coronary angiography, was> 3, indicating a more severe anatomical lesion of the coronary arteries in these patients. This pathology was associated primarily with an increase in the incidence of eccentric left ventricular hypertrophy. A similar association has been established with regard to the development of left ventricular diastolic dysfunction.


2016 ◽  
pp. 102-107
Author(s):  
Diana Moreva

Diseases of the circulatory system are the most common pathology in Ukraine and cover 26,2 mln. Population 12,3 mln ukrainians suffer from hypertension (AH). Gastroesophageal reflux disease (GERD) is recognized by the World Organization of Gastroenterology disease of the XXI century. Given the common risk factors for hypertension coronary heart disease (CHD) and the question of GERD studies of the combined flow of these diseases and to optimize the treatment of these patients. The objective: to determine the characteristics of intracardiac hemodynamics in patients with hypertension combined with chronic ischemic heart disease on the background of GERD and the determination of the combined effects of antihypertensive and antireflux therapy on the structural-functional state of the left ventricular myocardium. Patients and methods. We examined 107 patients aged 44 to 78 years, with an established diagnosis of hypertension stage I and II in combination with chronic ischemic heart disease. Research methods included anthropometric studies, biochemical blood analysis, ambulatory blood pressure monitoring, the daily ECG monitoring, esophagogas-troduodenoscopy (EGD), echocardiography (echocardiography), testing. Results. Comorbidity for hypertension, chronic ischemic heart disease and GERD is associated with a higher frequency of abdominal type of obesity and the metabolic syndrome according to IDF criteria, significantly higher percentage of patients with grade II and III obesity. That in turn is reflected in the features of the structural1functional state of the left ventricle (LV), which manifests an increase in the number of patients with more severe degrees of left ventricular hypertrophy. Related GERD is associated with a large percentage of cases of concentric hypertrophy of the left ventricle, and a greater prevalence of diastolic dysfunction. The combination of antihypertensive and antireflux therapy for 12 weeks of treatment was reflected in the significant decrease in the weight of the index parameters of left ventricular myocardium (LVMI) and relative wall thickness index and reliable positive dynamics of indicators of left ventricular diastolic function. Conclusion. Patients with hypertension combined with chronic ischemic heart disease with comorbidity with GERD have a higher prevalence of factors of cardiovascular risk. Related GERD is associated with a more severe degree of left ventricular hypertrophy, with a large percentage of cases of concentric hypertrophy of the left ventricle, and a greater prevalence of diastolic dysfunction. A combination of antihypertensive and antireflux therapy for 12 weeks of treatment promoted significant reduction in myocardial mass index indicators LV (LVMI) and relative wall thickness index and had a significant impact on the normalization of LV diastolic function.


2020 ◽  
Vol 22 (2) ◽  
pp. 70-73
Author(s):  
A. N. Kuchmin ◽  
M. Y. Yaroslavtcev ◽  
N. V. Afendikov ◽  
E. P. Galova ◽  
K. B. Evsukov ◽  
...  

The indicators of global and segmental longitudinal deformation of the left ventricular myocardium are presented and analyzed in patients suffering from coronary heart disease. The latter, as before, remains one of the urgent diseases of the circulatory system. To verify and determine management tactics for patients suffering from coronary heart disease, coronary angiography is performed. Indications for its implementation are based on the results of exercise tests, in particular, stress echocardiography. However, its implementation can be difficult due to poor visualization of the walls of the left ventricle, and the conclusion is not without subjectivity. One of the modern methods for assessing the contractility of the left ventricular myocardium, both global and segmental, is the spatial displacement of the myocardial structure (speckle-tracking- echocardiography). The technique automatically calculates the longitudinal deformation of the myocardium, expressed as a percentage of the initial values. It was found that the global and segmental longitudinal deformation of the left ventricular myocardium in the majority of the evaluated segments in the examined patients did not differ before loading. When conducting a stress test, the exact opposite dynamics of changes in the parameters of the global and segmental longitudinal deformation of the left ventricular myocardium is observed. So, in patients with a high risk of complications of coronary heart disease, a decrease in these indicators was observed, in patients without a risk of complications, on the contrary, their increase was observed, which indicates an increase in myocardial contractility during physical exertion. It was revealed that the indicator of global longitudinal deformation of the left ventricular myocardium is highly informative. The lower value of the decrease in the global longitudinal deformation of the left ventricular myocardium was calculated, which can serve as an additional indication for coronary angiography.


2018 ◽  
Vol 2 (5) ◽  
pp. 159-162
Author(s):  
Олеся Ефремова ◽  
Olesya Efremova ◽  
Людмила Брегель ◽  
Lyudmila Bregel ◽  
Владимир Субботин ◽  
...  

The article describes the observation of a child with a very rare combination of noncompact left ventricular myocardium and coronary dilatation in type 1 neurofibromatosis (NF 1). The first of these complications, undifferentiated cardio- myopathy, also known as noncompact myocardium, is not described in combination with NF 1 in available literature, although cases of hypertrophic cardiomyopathy in patients with NF 1 have been previously reported. Dilatation of the coronary arteries also refers to infrequent manifestations of vascular pathology against the background of neurofibro- matosis, and the combination of all three signs (NF 1, noncompact myocardium and coronary dilatation) has not yet been reported by other authors. When examining the patient, we found the characteristic signs of NF 1 (foci of “coffee” pigmentation on the skin, multiple nevuses, fibroids of the forearm, cognitive disorders), electrocardiogram features of left ventricular hypertrophy, negative T-tooth and ST-segment displacement 1 mm below the isoline in Leads V4-6, in echocardiography - pronounced trabecularity, thinning of the compact myocardium layer and a “spongy myocardium” in the region of the left ventricle apex, dilatation of the coronary arteries. With magnetic resonance imaging, signs of noncompact myocardium of the left ventricle were found, with selective coronary angiography - slowing of the coronary blood flow. The patient receives the permanent treatment for heart failure and aspirin, his condition remains stable for 4 years of follow-up


2021 ◽  
pp. 62-65
Author(s):  
Polina Denisovna Samokhvalova ◽  
Nikita Dmitrievich Matveev ◽  
Vsevolod Vladimirovich Skvortsov

Stress-induced cardiomyopathy is a disease that entails a transient violation of the systolic and diastolic functions of the left ventricular myocardium with subsequent enlargement of the heart chambers, akinesia of the apical and middle segments and normo- or hyperkinesia of the basal segments in the absence of pronounced hemodynamic stenosis of the coronary arteries. To date, there is no reliable information about the pathogenesis, methods of therapy and possible prognosis of this disease, so there is a need for further research.


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