Dynamics of heart failure and left ventricular parameters in patients with nonacute coronary artery...
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POSTER PRESENTATIONS S28 Heart, Lung and Circulation Poster Presentations 2008;17S:S4–S53 poor outcome was correlated with pathological Q waves in preoperative ECG and with an increased left ventricular end-systolic volume index (>100 ml/m 2 ). The presence of extensive reversible defects on preoperative thallium-201 scintigraphy is a strong predictor of postoperative recov- ery of myocardial function. A poor outcome of surgery can be expected in the presence of pathological Q waves on the preoperative ECG or when the left ventricular end systolic volume index exceeds 100 ml/m 2 . doi:10.1016/j.hlc.2007.11.069 Cardiac transplantation Yogesh Kumar Cardiac transplantation is the replacement of a person’s failing heart with a healthy heart from an organ donor. Cardiac transplant may be the only treatment option for patients who have heart failure caused by: • Cardiomyopathy; • Viral infections; • Prolonged high blood pressure; • Heart attack; or • Coronary artery disease. In rare cases, heart transplants are performed on patients who have valvular heart disease or congenital heart disease. Heart transplant recipients must take immunosuppres- sant medication for the rest of their lives and undergo frequent examinations. At the transplant centre, the recipient will undergo a series of tests to ensure that he or she is in satisfactory condition to receive the donor organ, including: • Blood tests; • Urine tests; and • Chest X ray. The procedure is performed under general anaesthesia. To begin the operation, the surgeon performs a ster- notomy and accesses the heart. The patient is connected to a heart–lung machine, which stops blood from circu- lating through the coronary arteries when the surgeon is working on the heart itself. Surgeons will then remove the patient’s failing heart by making incisions in the atria, aorta, and pulmonary arter- ies. The surgeon then connects the donor heart’s blood vessels to the patient’s. At this point, the heart either starts beating on its own or receives a shock to restart it. Once the new heart is beating without support from the heart–lung machine, the patient is weaned from the machine and the chest will be closed. The procedure takes between 3 and 5 h to complete. Post treatment guidelines and care: Transplant patient should follow these medication for the rest of his or her life: • Immunosuppressants; • Antibiotics; and • Medications to help counteract the side effects of the immunosuppressants, such as antacids, diuretics, and antihypertensives. doi:10.1016/j.hlc.2007.11.070 Dynamics of heart failure and left ventricular parame- ters in patients with nonacute coronary artery disease and recurrent ischaemia after percutaneous revascularization Vadim Kuznetsov ∗ , Grigoriy Kolunin, Igor Zyrianov, Albert Panin, Dmitriy Krinochkin, Marina Bessonova, Elena Gorbatenko Tyumen Cardiology Center, Russia Successful percutaneous revascularization (PR) may improve left ventricular (LV) function, remodelling and diminish severity of heart failure (HF) in patients with nonacute coronary artery disease (CAD). But dynamics of HF and LV parameters in patients after PR with recurrent ischaemia remain unclear. Aim: To assess and compare dynamics of HF and LV parameters in patients with nonacute CAD after PR hav- ing recurrent ischaemia and patients with nonacute CAD received conservative therapy. We examined 141 patients with nonacute CAD before and 1–87 months (mean 16 ± 14.6) after angiographically successful PR and signs of recurrent ischaemia: 57 with angiographic restenosis of a target vessel (group 1A) and 84 without (group 1B) and 83 patients with nonacute CAD received conservative medical therapy (group 2). Groups were matched for age, sex, cardiovascular risk factors and duration between first and second examinations. Results: The prevalence of patients with more severe HF (II–IV classes NYHA) increased significantly in group 2 only (from 53 to 71%, p = 0.007) and was unchanged in groups 1A and 1B. According to echocardiographic data in group 2 LV ejection fraction decreased (from 54.7 ± 7.7 to 51.5 ± 9.2%, p = 0.003), LV end diastolic diameter increased (from 50.8 ± 3.5 to 52.1 ± 4.5 mm, p = 0.029) as well as the extent of LV wall motion abnormalities (from 17 ± 14.5 to 21.3 ± 16.9%, p = 0.024). Those parameters did not change significantly in group 1A. In group 1B LV ejection frac- tion increased (from 53.4 ± 7.9 to 55.3 ± 6.8%, p = 0.015), LV end diastolic diameter and the extent of LV wall motion abnormalities were unchanged. Conclusion: There were no negative dynamics of HF and LV parameters in patients with nonacute CAD having recurrent ischaemia after PR even with restenosis of a target vessel. The dynamics of HF and LV parameters severity were worse in CAD patients received conservative medical ther- apy compared to patients with recurrent ischaemia after PR. doi:10.1016/j.hlc.2007.11.071
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S28 Heart, Lung and CirculationPoster Presentations 2008;17S:S4–S53
poor outcome was correlated with pathological Q waves inpreoperative ECG and with an increased left ventricularend-systolic volume index (>100 ml/m2). The presence ofextensive reversible defects on preoperative thallium-201scintigraphy is a strong predictor of postoperative recov-ery of myocardial function. A poor outcome of surgery canbe expected in the presence of pathological Q waves on thepreoperative ECG or when the left ventricular end systolicvolume index exceeds 100 ml/m2.
doi:10.1016/j.hlc.2007.11.069
Cardiac transplantation
Yogesh Kumar
Cardiac transplantation is the replacement of a person’sfailing heart with a healthy heart from an organ donor.Cardiac transplant may be the only treatment option forpatients who have heart failure caused by:
• Cardiomyopathy;• Viral infections;• Prolonged high blood pressure;• Heart attack; or• Coronary artery disease.
In rare cases, heart transplants are performed onpatients who have valvular heart disease or congenital
• Medications to help counteract the side effects of theimmunosuppressants, such as antacids, diuretics, andantihypertensives.
doi:10.1016/j.hlc.2007.11.070
Dynamics of heart failure and left ventricular parame-ters in patients with nonacute coronary artery disease andrecurrent ischaemia after percutaneous revascularization
Vadim Kuznetsov ∗, Grigoriy Kolunin, Igor Zyrianov,Albert Panin, Dmitriy Krinochkin, Marina Bessonova,Elena Gorbatenko
Tyumen Cardiology Center, Russia
Successful percutaneous revascularization (PR) mayimprove left ventricular (LV) function, remodelling anddiminish severity of heart failure (HF) in patients withnonacute coronary artery disease (CAD). But dynamics ofHF and LV parameters in patients after PR with recurrentischaemia remain unclear.
Aim: To assess and compare dynamics of HF and LVparameters in patients with nonacute CAD after PR hav-ing recurrent ischaemia and patients with nonacute CADreceived conservative therapy.
We examined 141 patients with nonacute CAD beforeand 1–87 months (mean 16 ± 14.6) after angiographicallysuccessful PR and signs of recurrent ischaemia: 57 with
heart disease.Heart transplant recipients must take immunosuppres-
sant medication for the rest of their lives and undergofrequent examinations.
At the transplant centre, the recipient will undergo aseries of tests to ensure that he or she is in satisfactorycondition to receive the donor organ, including:
• Blood tests;• Urine tests; and• Chest X ray.
The procedure is performed under general anaesthesia.To begin the operation, the surgeon performs a ster-
notomy and accesses the heart. The patient is connectedto a heart–lung machine, which stops blood from circu-lating through the coronary arteries when the surgeon isworking on the heart itself.
Surgeons will then remove the patient’s failing heart bymaking incisions in the atria, aorta, and pulmonary arter-ies. The surgeon then connects the donor heart’s bloodvessels to the patient’s. At this point, the heart either startsbeating on its own or receives a shock to restart it. Once thenew heart is beating without support from the heart–lungmachine, the patient is weaned from the machine and thechest will be closed. The procedure takes between 3 and5 h to complete.
Post treatment guidelines and care:Transplant patient should follow these medication for
the rest of his or her life:
• Immunosuppressants;• Antibiotics; and
angiographic restenosis of a target vessel (group 1A) and84 without (group 1B) and 83 patients with nonacute CADreceived conservative medical therapy (group 2). Groupswere matched for age, sex, cardiovascular risk factors andduration between first and second examinations.
Results: The prevalence of patients with more severe HF(II–IV classes NYHA) increased significantly in group 2only (from 53 to 71%, p = 0.007) and was unchanged ingroups 1A and 1B. According to echocardiographic data ingroup 2 LV ejection fraction decreased (from 54.7 ± 7.7 to51.5 ± 9.2%, p = 0.003), LV end diastolic diameter increased(from 50.8 ± 3.5 to 52.1 ± 4.5 mm, p = 0.029) as well as theextent of LV wall motion abnormalities (from 17 ± 14.5 to21.3 ± 16.9%, p = 0.024). Those parameters did not changesignificantly in group 1A. In group 1B LV ejection frac-tion increased (from 53.4 ± 7.9 to 55.3 ± 6.8%, p = 0.015), LVend diastolic diameter and the extent of LV wall motionabnormalities were unchanged.
Conclusion: There were no negative dynamics of HF andLV parameters in patients with nonacute CAD havingrecurrent ischaemia after PR even with restenosis of atarget vessel.
The dynamics of HF and LV parameters severity wereworse in CAD patients received conservative medical ther-apy compared to patients with recurrent ischaemia afterPR.
doi:10.1016/j.hlc.2007.11.071
