Surgical Treatment of Ischemic Cardiomyopathy: Current State of the Problem

Шипулин, В. М.; Pryakhin, A. S.; Андреев, С. Л.; Kozlov, B. N.

doi:10.18087//cardio.2019.9.n329

Cited by 8 publications

(10 citation statements)

References 67 publications

(90 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Хирургическая коррекция часто является методом выбора при лечении данной патологии. Однако до 30% пациентов в течение первого года после операции претерпевают повторное ремоделирование ЛЖ [3].…”

Section: Discussionunclassified

“…Хирургическое лечение ишемической кардиомиопатии (ИКМП), включающее максимальную реваскуляризацию, реконструкцию полости левого желудочка (ЛЖ) и пластику митрального клапана, имеет преимущество перед консервативной терапией [1][2][3]. Однако у части пациентов в отдаленном периоде после оперативного лечения наблюдается повторное ремоделирование ЛЖ [3], что ассоциировано с неблагоприятным прогнозом [4]. Таким образом, можно сделать вывод о том, что имеющиеся критерии не позволяют в полной мере прогнозировать отдаленные исходы и производить отбор пациентов с ИКМП для хирургического лечения.…”

unclassified

“…Материал и методы В исследование проспективно были включены пациенты с диагнозом ИКМП [3]. Критериями ис -ключения являлись противопоказания к проведению стресс-теста с инотропной стимуляцией, воспалительные заболевания миокарда, наличие выраженных гематологических, неврологических расстройств, других состояний, препятствующих выполнению исследования, отказ пациента от участия в исследовании.…”

unclassified

See 2 more Smart Citations

Long-term prognosis of left ventricular re-remodeling after surgery of ischemic cardiomyopathy: the potential of tomographic radionuclide ventriculography

et al. 2020

Self Cite

View full text Add to dashboard Cite

Aim. To assess the potential of stress tomographic radionuclide ventriculography (T-RVG) in long-term prognosis of left ventricular (LV) re-remodeling after surgery of ischemic cardiomyopathy.Material and methods. Thirty patients with ischemic cardiomyopathy, before surgical treatment, underwent resting T-RVG and with increasing doses of dopamine (5/10/15 pg/kg/min (5 min/dose). All patients underwent two-dimensional echocardiography before surgery, in the short- (7-14 days) and long-term postoperative period. In the long-term postoperative period (476±36 days), the patients were divided into two groups: group 1 (n=19) — patients with ongoing LV remodeling (increase in the LV end-systolic volume (ESV) or decrease <10% relatively short-term postoperative period), group 2 (n=11) — patients with decreased LV ESV >10%.Results. The results revealed significant differences between the groups in the dynamics (Δ) of the LV ejection fraction (EF) (%) (2 (2;8); 11 (5;12), p=0,02), peak ejection rate (%) (32 (14;51); 63 (34;79), p=0,009), LV dyssynchrony (PSDo (3 (0;7); -2 (-9;3), p=0,004); Entropy (%) (2 (-1;6); 0 (-4;2), p=0,01)). Univariate regression showed that ΔLVEF (odds ratio (OR), 0,88; confidence interval (CI), 0,8; 0,97; p=0.008), ΔLVPSD (OR, 1,13; CI, 1,03; 1,25; p=0,005), and coronary stenosis >75% (OR, 4,25; CI, 1,57; 11,48; p=0,001) had a predictive value. According to the ROC-analysis, the sensitivity, specificity, and AUC were 87%, 64% and 0,727 for ΔLVPSD (threshold >-1); 84%, 46% and 0,691 for coronary stenosis >75% >75% (threshold >2); 65%, 82% and 0,674 for ΔLVEF (threshold ≤4), respectively. The logistic model, which included these parameters and the presence of diabetes, showed a significantly greater AUC (0,907, p<0,05) compared with these indicators taken separately.Conclusion. Preoperative values of ΔLVEF and ΔLVPSD obtained with stress T-RVG have prognostic significance in relation to LV long-term re-remodeling.

show abstract

Section: Discussionunclassified

unclassified

See 1 more Smart Citation

Long-term prognosis of left ventricular re-remodeling after surgery of ischemic cardiomyopathy: the potential of tomographic radionuclide ventriculography

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…The diagnosis of "ischemic cardiomyopathy" (ICM) characterizes patients with CHF and CHD in history. 2 Clinically, this pathology is symptomatic in a significant decrease in left ventricular (LV) ejection fraction (EF), heart chamber dilatation, and the presence of atherosclerotic lesions of the coronary arteries. 3,4 The disease is characterized by progressive LV remodeling, thinning of its walls with an aneurysm formation, impaired cardiac hemodynamic parameters, and changes in myocardial morphology at the microscopic and ultrastructural levels.…”

Section: Introductionmentioning

confidence: 99%

Morphological and immunological markers of repeated heart remodeling after surgical reconstruction of the left ventricle in ischemic cardiomyopathy

Shipulin

Андреев

Belyaeva

et al. 2023

Asian Cardiovasc Thorac Ann

Self Cite

View full text Add to dashboard Cite

Introduction Effective treatment of patients with ischemic cardiomyopathy (ICM) is one of the most challenging issues in modern cardiac surgery. The aim of this study was to assess the state of cardiomyocytes and myocardial extracellular matrix, as well as to identify informative markers of an unfavorable prognosis for surgical treatment of ICM. Materials and methods We retrospectively reviewed patients who underwent surgical treatment of ICM between 2011 and 2018 at a single center. Patients were divided into groups depending on the presence of repeated left ventricle (LV) remodeling in one-year follow-up after surgical reconstruction of the LV in ICM patients. Results A total of 45 patients with ICM were reviewed. The mean age of the patients was 57.9 ± 7.8 years. According to the results of the study, the area of cardiomyocyte nuclei differed statistically significantly among the regions with varying degrees of impaired local contractility ( p = 0.042). According to the results of the pairwise comparison in dyskinetic areas of the myocardium, the area of cardiomyocyte nuclei was higher than in normokinetic areas ( p = 0.042). A moderate positive correlation was found between the LV ejection fraction measured in one-year follow-up period after surgery and the number of CD163-positive cells ( p = 0.012). Conclusion In the myocardium of patients with LV reverse remodeling in the long-term postoperative period, perivascular fibrosis occurs more frequently than in patients with progressive LV remodeling. The number of M2-anti-inflammatory macrophages prevails in the myocardium of the patients with reverse remodeling compared with patients with progressive remodeling.

show abstract

“…Ischemic cardiomyopathy (ICMP) is the main cause of mortality from chronic heart failure (CHF), which demonstrates the priority importance of searching for treatment modalities of this disease [1] . At the same time, non-surgical treatment of ICMP is currently similar to that in coronary heart disease (CHD) without ICMP and surgical correction, in addition to bypass surgery, includes techniques for reconstructing of a left ventricular cavity, the expediency of which at ICMP is still being discussed [2] , [3] .…”

Section: Introductionmentioning

confidence: 99%

Galectin 3 and non-classical monocytes of blood as myocardial remodeling factors at ischemic cardiomyopathy

Chumakova

Уразова

Шипулин

et al. 2021

IJC Heart & Vasculature

Self Cite

View full text Add to dashboard Cite

Aims To identify an imbalance of cardiac remodeling mediators and monocytes subpopulation in blood, distribution of myocardium macrophages in patients with ischemic cardiomyopathy (ICMP). Methods The study engaged 30 patients with ICMP, 26 patients with coronary heart disease (CHD) without ICMP, 15 healthy donors. Concentrations of TGFβ, MMP-9, MCP-1, galectin-3 were measured in plasma of blood from the coronary sinus and peripheral blood in CHD patients, as well as in peripheral blood in healthy donors, by enzyme immunoassay method. The ration of classical, intermediate, non-classical, transitional monocytes in peripheral blood of patients and healthy donors was assessed by flow cytometry (expression CD14, CD16); the content of CD68+ macrophages in myocardium – by immunohistochemistry method. Results In both samples of blood, the content of galectin-3 in patients with ICMP was higher than in CHD patients without ICMP and the level of TGFβ was comparable between the groups. At ICMP, the concentration of MMP-9 in sinus blood was higher than that in CHD patients without ICMP in whom an excess of MCP-1 in the general blood flow was determined. The density of distribution of CD68+ cells in the myocardium in patients with ICMP was higher in the perianeurysmal zone than in the right atrium appendage. ICMP was characterized by a deficiency of non-classical monocytes, and CHD without ICMP – by an excess of intermediate cells in peripheral blood. Conclusion Myocardium remodeling at ICMP is mediated by not so much TGFβ but intracardiac galectin-3, which determines the subpopulation composition of blood monocytes.

show abstract

Surgical Treatment of Ischemic Cardiomyopathy: Current State of the Problem

Cited by 8 publications

References 67 publications

Long-term prognosis of left ventricular re-remodeling after surgery of ischemic cardiomyopathy: the potential of tomographic radionuclide ventriculography

Long-term prognosis of left ventricular re-remodeling after surgery of ischemic cardiomyopathy: the potential of tomographic radionuclide ventriculography

Morphological and immunological markers of repeated heart remodeling after surgical reconstruction of the left ventricle in ischemic cardiomyopathy

Galectin 3 and non-classical monocytes of blood as myocardial remodeling factors at ischemic cardiomyopathy

Contact Info

Product

Resources

About