Л.М. Бабій, Н.П. Строганова, С.Ю. Савицький, Ю.О. Хоменко. Early and remote cardiac remodeling in post-infarction patients depending on localization of the infarction

The aim – to compare parameters of early and remote left ventricular (LV) remodeling after myocardial infarction (MI) depending on infarction localization.

Material and methods. Оne hundred patients after Q-wave myocardial infarction (MI), average age 55.6±4.6 years, were included: 39 – in acute period of MI, 61 – at longer terms after MI. Echocardiography and study of blood aldosterone level were performed in all patients. The division of patients into groups was based on localization of MI, LV systolic function and arterial hypertension in anamnesis.

Results. During acute period of MI LV ejection fraction was higher in posterior-lateral localization of MI (than in anterior MI; increase of end-diastolic volume was similar, but end-systolic volume, index of contractile function (ICF) and index of residual myocardial reserve (IRMR) were higher in anterior MI. The influence of aldosterone level and arterial hypertension upon LV remodeling was shown. Analysis of echocardiographic parameters during remote terms after MI didn’t reveal significant differences depending on MI localization, except more decrease of ICF and increase of IRMR after anterior MI. Three cardiodynamic types of the remote LV remodeling were shown.

Conclusions. Compared to posterior-lateral MI, acute period of anterior MI is associated with more disturbances of hemodynamics due to anatomical characteristics of myocardium and blood supply peculiarities. Comparison of exercise tolerance and LV function parameters at remote terms after MI makes possible to evaluate LV myocardial reserve which might influence medical treatment.

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