Surgical and Endovascular Revascularization of Myocardium in Multivessel Disease

Гордеев, И. Г.; Лебедева, А. Ю.; Волов, Н. А.; Grishina, I. S.; Семиохина, А. С.

doi:10.15829/1560-4071-2016-2-90-94

Cited by 3 publications

(1 citation statement)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Клинические рекомендации указывают на необходимость отсроченного стентирования инфарктнесвязанных КА до выписки из стационара. Подобный подход снижал риск развития инфаркта миокарда (ИМ), кардиальной смерти и рефрактерной стенокардии [3][4][5][6]. Целесообразность реваскуляризации бессимптомных стенозов с неопределенной гемодинамической значимостью не доказана [7].…”

Section: автор для перепискиunclassified

The Role of Residual Stenosis of the Coronary Arteries in the Dynamics Systolicdiastolic Left Ventricular Function after Acute Coronary Syndrome

Shveс

Поветкин

2020

Kardiologiia

View full text Add to dashboard Cite

Objective. The aim of the research under consideration was to study the dynamics of a local systolic-diastolic function of patients with various ischemic heart disease (IHD) progressions after survival of an acute coronary syndrome (ACS) provided there are residual stenoses of coronary arteries.Materials and Methods. There were 112 patients suffering from ACS who took part in the research. The diagnosis was verified (acute myocardial infarction or unstable angina) in accordance with the recommendations of European Society of Cardiology (ESC). All patients were divided into two groups depending on the occurrence of major acute cardiac events (MACE): 59 patients with aggravated IHD progression and 152 patients with non-aggravated course. Echo-cardiography was performed on a scanner Philips iE33 (the Netherlands) with a consideration to systolic and diastolic functions parameters of a left ventricle. Quantitative analysis of the left ventricle was executed in the mode of Tissue Doppler Imaging (TDI) and according to the method of tracing the patches of the ultra-sound image gray scale (ST).Results. In the course of the aggravated IHD a decrease in systolic-diastolic function of left ventricle has been discovered. It has been found out that the amount of the systolic peak of longitudinal strain of the left ventricle anteroseptal wall less than 12% is associated with a greater extent of coronary atherosclerosis and aggravated progression of IHD. TDI and ST methods have enabled to reveal that in the course of non-aggravated IHD the contractility and the diastolic function of the left ventricle anteroseptal wall improve in combination with the increase in the contractility of the left ventricle inferolateral wall. During an aggravated IHD progression the contractility and diastolic function of the left ventricle anteresoptal wall decreases without an increase in contractility and diastolic function of the inferior and inferolateral walls of the left ventricle. The reason for such results might be a progressing myocardial ischemia of the left ventricle anteroseptal wall despite the sufficient anterior interventricular artery stenting. The presence of the relevant residual stenoses of the circumflex and right coronary arteries increases the possibility of the aggravated IHD progressing especially by the end of the fourth year of observation.Conclusion. The disbalance of the local contractility of anterior, inferior and inferolateral left ventricle walls in the course of aggravated IHD is connected with the CA residual stenoses presence and forwards the decrease in global systolic-diastolic function of the left ventricle. The final results can serve as a foundation for optimization of recommendations for performing PCI on the patients with multivessel disease of CA.

show abstract

Section: автор для перепискиunclassified

The Role of Residual Stenosis of the Coronary Arteries in the Dynamics Systolicdiastolic Left Ventricular Function after Acute Coronary Syndrome

Shveс

Поветкин

2020

Kardiologiia

View full text Add to dashboard Cite

show abstract

Efficiency of everolimus-eluting stents of different generations after functionally adequate myocardial revascularization in patients with diffuse and multivessel coronary artery disease

Максимкин¹,

Bolivogui²,

Chepurnoy³

et al. 2023

Kardiol. serdechno-sosud. khir.

View full text Add to dashboard Cite

Long-term results of percutaneous coronary interventions in patients with diffuse and multivessel coronary artery diseases

Максимкин

Bolivogui

Шугушев

et al. 2022

Kompleks. probl. serdečno-sosud. zabol.

View full text Add to dashboard Cite

Highlights. Two-year results of stenting in patients with diffuse and multivessel coronary artery lesions performed using intravascular research and control methods (optical coherence tomography, blood flow fractional reserve) are presented. A low incidence of myocardial infarction, repeated interventions and a high level of survival, free from significant cardiovascular complications, were noted when using intravascular research methods in patients during percutaneous coronary intervention in comparison with the patients who did not undergo intravascular methods.Aim. To evaluate the two-year results of percutaneous coronary interventions (PCI) in patients with diffuse and multivessel coronary lesions.Methods. 128 patients were included in the study and divided into two groups. In group I (n = 62) PCI was performed using intravascular imaging methods, in group II (n = 66) no intravascular imaging methods (retrospectively) were used. The measurement of fractional flow reserve (FFR) in diffusely altered arteries was performed against the background of maximum hyperemia between stenoses by pulling the sensor starting from the distal segment. Initially, the most distal hemodynamically significant stenosis underwent the stenting. Then, a repeated measurement of FFR was performed and it showed if the further stenting was needed. The results of stenting, as well as the determination of the stent implantation area were carried out by the method of optical coherence tomography.Results. 12 months after PCI the results of treatment were checked in all patients and after 24 months – in 106 patients (56 and 50, respectively, in groups I and II). The achievement of complete (functionally adequate, according to FFR measurements) myocardial revascularization was achieved in 93.5% of patients from group I, while the result in the control group was only 56% of patients. The average number of stenoses in the target non-occluded artery according to angiography and after FFR measurement was the following: in patients with two-vessel lesions – 2.95±0.65 and 1.82±0.88, respectively, and in patients with three-vessel lesions – 2.96±0.6 and 2.24±0.76, respectively (p = 0.0024). After 12 months of follow-up, significant differences were observed between groups I and II in the frequency of myocardial infarction (1.8 and 4.0%, respectively; χ2 = 5.172) and repeated interventions (3.6 and 16.0%, respectively; χ2 = 8.114). By the 24th month of follow-up, among the observed patients, the total frequency of myocardial infarction, repeated interventions and cardiac death were significantly higher in patients of group II compared with group I and they were 45.5 and 9.6%, respectively (χ2 = 14.784; p<0,0001).Conclusion. Long-term results of PCI in patients with diffuse and multivessel coronary lesions using intravascular imaging methods (optical coherence tomography and FFR measurements) are characterized by low cardiac complications, compared with patients operated without imaging methods.

show abstract

Surgical and Endovascular Revascularization of Myocardium in Multivessel Disease

Cited by 3 publications

References 8 publications

The Role of Residual Stenosis of the Coronary Arteries in the Dynamics Systolicdiastolic Left Ventricular Function after Acute Coronary Syndrome

The Role of Residual Stenosis of the Coronary Arteries in the Dynamics Systolicdiastolic Left Ventricular Function after Acute Coronary Syndrome

Efficiency of everolimus-eluting stents of different generations after functionally adequate myocardial revascularization in patients with diffuse and multivessel coronary artery disease

Long-term results of percutaneous coronary interventions in patients with diffuse and multivessel coronary artery diseases

Contact Info

Product

Resources

About