Results of the Ultrasound Study of Intracardial Hemodynamics in Patients with Ischemic Heart Disease in Combination with Arterial Hypertension and Complicated by Chronic Heart Failure 2A and 2B

Nina Matsegora, Nataliia Mitasova

Abstract


Objective. To conduct a comprehensive study of patients with ischemic heart disease (IHD) in combination with arterial hypertension (AH) complicated by chronic heart failure (HF) 2A and 2B, by studying parameters of intracardiac hemodynamics considering the pressure in the pulmonary artery.

Research results. We examined 120 patients with coronary heart disease in combination with hypertension aged 44 to 90 years old (mean age 72.29 ± 1.66), the majority were men (86.7%). All patients were divided into two groups according to the degree of heart failure: HF 2A - 54 persons, with HF 2B - 66 people. The groups were compared in age, gender, functional class of IHD, severity of AH and HF.

Analysis of heart ultrasound showed the following. In IHD in combination with hypertension, complicated by HF 2A, the pressure in the pulmonary artery rises in an average to 46.46 ± 3.64 mm Hg and it increases in HF 2B to 57.00 ± 5.19 mm Hg., that corresponding to the average level of pulmonary hypertension (p<0.01); at the same time, the fraction of ejection of left ventricle in the first patients decreases moderately up to 45.96 ± 2.01%, in others - to 39.93 ± 1.99% (p ˂0.01).

In patients with IHD in combination with hypertension complicated by chronic heart failure the structural and functional changes are formed on the side of the left heart, accompanied by an increase in their size due to hypertrophy, formation of stagnant phenomena, regurgitation, functional state disorders by the restrictive type, progressive systolic and diastolic dysfunction, increased pressure in the pulmonary artery.

Conclusions. Consideration of pulmonary hypertension, along with other parameters of intracardiac hemodynamics, is an important component in determining the degree and nature of heart failure, which requires the selection of adequate and timely therapeutic tactics.


Keywords


IHD in combination with AH; CHF; pulmonary hypertension; heart ultrasound

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References


Diahnostyka i likuvannia khronichnoyi sertsevoyi nedostatnosti: rekomendaciyi Yevropeyskoho tovarystva kardiolohiv, 2016; Specialnyy vypusk. Dodatok #2 do zhurnalu "Sertseva nedostatnist'" #2, veresen 2016. 80p.

Kozhuhov SM, Parkhomenko OM. Cardiac insufficiency with preserved left ventricular ejection fraction. Novosti meditsiny i farmatsii. 2016; 576: 40-43.

Maslova AP, Libis RA. Diastolic dysfunction of the left ventricle with a combination of chronic heart failure and permanent form of atrial fibrillation. Serdechnaya nedostatochnost. 2012; 13(4): 205-208.

Orders of MOH of Ukraine dated 24.05.2012 #384, dated 23.11.2011 # 816, dated 03.07.2006 # 436 "Pro zatverdzhennia ta vprovadzhennia mediko-tekhnolohichnykh dokumentiv zi standartizatsiyi medychnoyi dopomohy pry arterialniy hipertenziyi", "…ishemichniy khvorobi sertsia'", "… khronichniy sertseviy nedostatnosti' ".

Nazzareno Galie, Alessandro Manes Pulmonary hypertension. Kardiolohiya i revmatolohiya . 2015; 546: 35-58.

Noreyko BV, Noreyko SB. Pulmonary hypertension: pathogenesis and new possibilities of diagnosis. Zdorovya Ukrayiny. Pulmonolohiya. 2011; 6(259): 49-50.

Aliavi BA, Mukhamedova MM,. Ishakov ShA, Babayev MA. Peculiarities of hemodynamics in patients with chronic heart failure depending on the functional class and the ejection fraction. Bukovynskyy medychnyy visnyk. 2012; 16(4(64)): 3-6.

Kovalenko VM, Lutaya MI, Sirenko YuM, Sichova OS. Cardio-vascular diseases. Classification, diagnostic standards and treatment. MORION. 2016; 192.

Stable ischemic diseases of the heart (Adapted clinical guideline, based on proofs). Arterialna hipertenziya. 2016; 2(46): 113-126.

Larina VN, Bart BYa. Chronic cardiac failure: peculiarities of clinical manifestations in senile age. Novosti meditsiny i farmatsii. Kardiologiya i revmatologiya. 2015; 546: 25-28.

Ceia E, Fonseca C, Mota T. et al. Prevalence of chronic heart failure in Southwestern Europ: the EPICA study. Eur. J. Heart Failure. 2002; 4: 531-539. DOI: https://doi.org/10.1016/S1388-9842(02)00034-X

Lang R, Badano L, Tsang W. et al. EAE/ASE Recommendations for Image Acquisition and Display Using Three-Dimensional Echocardiography. Eur. Heart J. Cardiovasc. Imaging. 2012; 13 (1): 1-46. DOI: https://doi.org/10.1093/ehjci/jer316 [PMid:22275509]

Paulus W, Tschope C, Sanderson J. et al. How to diagnose diastolic heart failure? Eur. Heart J. 2007; 28 (20): 2539-2550. DOI: https://doi.org/10.1093/eurheartj/ehm037 [PMid:17428822]




DOI: http://dx.doi.org/10.21802/gmj.2017.3.8

Copyright (c) 2017 Nina Matsegora, Nataliia Mitasova

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