[Right ventricular dilatation in patients with coronary heart disease without myocardial infarction: According to the data of the Coronary Angiography Surgery Registry].

Abstract:

AIM:To identify factors associated with right ventricular (RV) dilatation in patients with coronary heart disease (CHD) without prior myocardial infarction (Ml). SUBJECTS AND METHODS:Out of 16 839 patents from the Coronary Angiography Surgery Registry, the investigators selected patients with >75% stenosis in at least one coronary artery without acute or prior MI: 75 patients with echocardiographically detected RV dilatation and 1134 without RV dilatation. RESULTS:Among the patients with RV dilatation, there were more men (92% versus 80.2%; p=0.01 2). In this group, the mean body mass index (BMI) was higher (31.7±5.2 kg/m2 versus 30.1±4.7 kg/m2; p=0.01 9); there was more commonly higher NYHA functional class (FC) (III) chronic heart failure (CHF) (22.2% versus 12.5%; p=0.002), clinically relevant mitral regurgitation (29.4% versus 4.0%; all ps<0.001), and cardiac rhythm and conduction disturbances (45.5% versus 17.8%; p<0.001) in rarer severe FC (III-IV) exertional angina (30.3% versus 52.8%; p=0.007). The groups were different as evidenced by coronarography and major blood biochemical indicators. Decreased myocardial contractility (odds ratio (OR), 4.22; p=0.002), male sex (OR, 4.03;p=0.007), cardiac rhythm and conduction disturbances (OR, 2.98; p<0.001), clinically relevant mitral regurgitation (OR, 2.34; p=0.001); higher FC CHF (OR, 1.87; p=0.034), BMI (OR, 1.08; p=0.01 0), and lower FC exertional angina (OR, 0.42; p=0.001) demonstrated an independent relationship to RV dilatation, as evidenced by a multivariateanalysis. CONCLUSION:In the patients with CHD without MI, RV dilatation is independently related to male sex, left ventricular functional characteristics, and higher BMI. :Цель исследования. Выявить факторы, связанные с дилатацией правого желудочка (ПЖ), у больных ишемической болезнью сердца (ИБС) без перенесенного инфаркта миокарда (ИМ). Материалы и методы. Из 16 839 пациентов 'Регистра проведенных операций коронарной ангиографии' отобрали больных со стенозом >75% как минимум одной коронарной артерии без острого или анамнестического ИМ: 75 - с дилатацией ПЖ, выявленной эхокардиографически и 1134 - без дилатации ПЖ. Результаты. Среди пациентов с дилатацией ПЖ оказалось больше мужчин (92% против 80,2%; р=0,012). В этой группе выше средний индекс массы тела - ИМТ (31,7±5,2 кг/м2 против 30,1±4,7 кг/м2; р=0,019), чаще выявляли более высокий (III) функциональный класс (ФК) хронической сердечной недостаточности (ХСН) по классификации NYHA (22,2% против 12,5%; р=0,002), клинически значимую митральную регургитацию (29,4% против 4,0%; все р<0,001), нарушения ритма и проводимости сердца (45,5% против 17,8%; р<0,001) при более редких тяжелых (III-IV) ФК стенокардии напряжения (30,3% против 52,8%; р=0,007). По данным коронарографии и основным биохимическим показателям крови группы не различались. По результатам многофакторного анализа независимую связь с дилатацией ПЖ продемонстрировали снижение сократительной способности миокарда (ОШ 4,22; р=0,002), мужской пол (отношение шансов - 4,03; р=0,007), нарушения ритма и проводимости сердца (ОШ 2,98; р<0,001), клинически значимая митральная регургитация (ОШ 2,34; р=0,001), увеличение ФК ХСН (ОШ 1,87; р=0,034) и ИМТ (ОШ 1,08; р=0,010), снижение ФК стенокардии напряжения (ОШ 0,42; р=0,001). Заключение. Дилатация ПЖ у больных ИБС без ИМ независимо связана с мужским полом, параметрами, характеризующими функциональное состояние ЛЖ, и увеличением ИМТ.

journal_name

Ter Arkh

journal_title

Terapevticheskii arkhiv

authors

Kuznetsov VA,Yaroslavskaya EI,Pushkarev GS,Krinochkin DV,Bessonov IS,Gorbatenko EA

doi

10.17116/terarkh201587934-38

subject

Has Abstract

pub_date

2015-01-01 00:00:00

pages

34-38

issue

9

eissn

0040-3660

issn

2309-5342

journal_volume

87

pub_type

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