Correlation of Functional Values of Left Ventricular Myocardium and the Data of Subjective State of Patients with Chronic Coronary Occlusion
The aim of the investigation is to study the correlation of functional values of left ventricular myocardium and the data of subjective state of patients with chronic coronary occlusion according to echocardiography findings and a new technique of subjective state assessment of patients with incomplete myocardial revascularization.
Materials and Methods. The treatment results of 74 patients with coronary occlusion were analyzed. The 1st group consisted of 35 (47%) patients with chronic occlusion localized in the right coronary artery, the 2nd — 15 (20%) patients with chronic occlusion in anterior descending artery, the 3rd — 24 (33%) patients with chronic occlusion of circumflex branch of coronary artery. All the patients underwent complete clinical and instrumental examination including echocardiography, angiography and history taking of subjective state of patients. Subjective state of patients was assessed by an original technique three times: preoperatively, a day after admission; on the 3rd day after the operation, and 3 months after surgery. The results obtained were correlated with the effect of the disease and X-ray endovascular treatment on physical, psychological, emotional and social states of a person.
Conclusion. According to the technique of subjective state assessment of patients developed by the authors, incomplete X-ray endovascular myocardial revascularization contributes to the increase of psychological and social level functioning in early postoperative periods. In accordance with the echocardiography findings, complete recovery of left ventricular myocardial function in arterial occlusive disease can fail to be observed in early postoperative periods due to collateral myocardial hypoperfusion in the zone of chronic ischemia.
- Kim Hee-Yeol. Percutaneous recanalization of coronary chronic total occlusions: current devices and specialized wire crossing techniques. Korean Circ J 2010; May; 40(5): 209–215.
- Di Mario C., Werner G.S., Sianos G. et al. European perspective in the recanalisation of Chronic Total Occlusions (CTO): consensus document from the EuroCTO Club. EuroIntervention 2007; 3: 30–43.
- Werner G.S., Emig U., Mutschke O., Schwarz G., Bahrmann P., Figulla H.R. Regression of collateral function after recanalization of chronic total coronary occlusions: a serial assessment by intracoronary pressure and Doppler recordings. Circulation 2003; 108: 2877–2882.
- Hannan E.L., Wu C., Walford G. et al. Incomplete revascularisation in the era of drug-eluting stents. J Am Coll Cardiol Intv 2009; 2: 17–25.
- Cowley A.J., Wiens B.L., Segal R., Rich M.W., Santanello N.C., Dasbach E.J., Pitt B. Randomized comparison of losartan vs. captopril on quality of life in elderly patients with symptomatic heart failure: the losartan heart failure ELITE quality of life substudy. Quality of life research 2000; 9: 377.
- Margolis J.R. Incomplete revascularization: a valid strategy or suboptimal approach? Cardiac interventions today 2008; 55–58.
- Meier B., Luethy P., Finci L., Steffenino G.D., Rutishauser W. Coronary wedge pressure in relation to spontaneously visible and recruitable collaterals. Circulation 2008; 75: 906–913.
- Leaman D.M., Brower R.W., Meester G.T., Serruys P., van den Brand M. Coronary artery atherosclerosis: severity of disease, severity of angina pectoris and compromised left ventricular function. Circulation 1981; 63(2): 285–299.
- Meier B. Chronic total coronary occlusion angioplasty. Chathet Cardiovasc Diagn 2006; 25: 1–11.
- Cafagna D., Ponte Т., Burri R. The concept of quality of life in cardiac failure. Minerva Medica 1997; 88: 151–162.
- Remme W.J. Heart failure management: why evidence does not influence clinical practice. European Heart Journal Supplements 2000; 2(Suppl. I): 115–121.
- Gorkin L., Norvell N.K., Rosen R.C., Charles E., Shumaker S.A., Mclntyre K.M., Capone R.J., Kostis J., Niaura R., Woods P., Hosking J., Garses C., Handberg E., Ahern D.K., Follick M.J. for SOLVD Investigators. Assessment of quality of life as observed from the baseline data of the studies of left ventricular dysfunction (SOLVD) trial quality-of-life substudy. Am J Cardiol 1993; 71: 1069–1073.