Analysis of quantitative and qualitative indicators of myocardial function for planning and evaluation of the surgical treatment results in patients with coronary heart disease

Abstract

Coronary heart disease (CHD) is the main cause of the occurrence and progression of heart failure, as well as mortality among the adult population, both in Russia and around the world. Determining the functional state of the myocardium before surgery allows one to choose the right treatment strategy, methods of surgical correction of coronary disorders, and predict outcomes.Aim. The research aims at the improvement of methods for predicting revascularization outcomes by creating a mathematical model depending on the number of viable myocardium.Material and methods. We examined 118 patients with a diagnosis of CHD who underwent surgical correction of coronary blood fl ow disorders with the use of direct and indirect revascularization methods at the Pirogov National Medical Center. We analyzed correlation between gated-SPECT, Echocardiography and operation results.Results. An inverse strong correlation has been found between LV contractility after surgery and the preoperative amount of scar myocardium and the end diastolic volume (EDV) LV (p < 0.05, Spearman criterion). A direct correlation has been determined between the improvement of EF and the volume of the hibernated myocardium (p < 0.05, Spearman criterion). There is a model for predicting EF after revascularization: Ejection fraction (after revascularization)(%) = 70.99126 − 0.10490 × EDV (ml) + 0.38827 × hibernated myocardium(%) − – 0,50137 × scar myocardium (%).Conclusion. Statistical modeling based on quantitative and qualitative assessment of the functional state of the myocardium in patients with CHD with the use of gated-SPECT and Echocardiography is an actual and necessary way to fi nd optimal solutions in the treatment and rehabilitation of patients with CHD.