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Post a Comment Model of evaluation of the dynamics of left ventricular diastolic function in acute decompensated heart failure. Effect of ivabradin
- Authors: Karchikian P.O.1,2, Sayganov S.A.1,2
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Affiliations:
- North-Western State Medical University named after I.I. Mechnikov
- The Department of Hospital Therapy and Cardiology named after M.S. Kushakovsky
- Issue: Vol 10, No 3 (2018)
- Pages: 28-35
- Section: Original research
- URL: https://journal-vniispk.ru/vszgmu/article/view/10256
- DOI: https://doi.org/10.17816/mechnikov201810328-35
- ID: 10256
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Abstract
Aim — to reveal the connection between the initial morphofunctional characteristics of patients and the dynamics of changes in the diastolic function at the time of, as well as during 6 months of observation after the episode of acute decompensated heart failure against the background of standard therapy and with adding the If-channel blocker ivabradine.
Material and methods. We examined 127 patients hospitalized with the episode of the acute decompensated heart failure with a sinus rhythm and heart rate more than 85 beats per minute. Among them 67 patients received ivabradine in addition to standard therapy, 60 patients were in control group. A 6-minute walk test, echocardiography assessment of systolic and diastolic function, electrocardiography (heart rate and rhythm) were performed on the day of admission (except for the 6-minute walk test), in 1 and 6 months later.
Results. A scoring of the chance for positive dynamics of diastolic function was obtained in patients with acute decompensated heart failure, in the presence of certain initial characteristics of patients, such as: systolic pulmonary artery pressure < 37 mmHg (p < 0.005), heart rate < 95 beats per minute (p < 0.05), end diastolic size < 50 mm (p < 0.005), VE /Em* < 18 (p < 0.0005), end systolic size < 40 mm (p < 0.0005), and end systolic volume index < 40 ml/m2 (p < 0.0005), end diastolic volume index < 73 ml/m2 (p < 0.005), ejection fraction > 50% (p < 0.005), ivabradine intake (p < 0.05), relative wall thickness > 0,46 (p < 0.005), female. A relationship between improvement in diastolic function and improvement in results of 6-minute walk test was found: with a positive dynamics of diastolic function, patients began to walk a distance in the 6-minute walk test by 6,9 ± 2,9 meters more (p < 0.0005).
Conclusion. The data obtained in our study confirm the advisability of adding ivabradine to the standard therapy of patients with acute decompensated heart failure with the determined “useful” morphofunctional characteristics.
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##article.viewOnOriginalSite##About the authors
Pavel O. Karchikian
North-Western State Medical University named after I.I. Mechnikov; The Department of Hospital Therapy and Cardiology named after M.S. Kushakovsky
Author for correspondence.
Email: p1472141@mail.ru
ORCID iD: 0000-0001-8288-0352
кардиолог
Russian Federation, 41, Kirochnaya street, Saint-Petersburg, 191015Sergey A. Sayganov
North-Western State Medical University named after I.I. Mechnikov; The Department of Hospital Therapy and Cardiology named after M.S. Kushakovsky
Email: ssayganov@gmail.com
Russian Federation, 41, Kirochnaya street, Saint-Petersburg, 191015
References
- Sherif F, Nagueh MD, Chair MD, et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2016;29:277‑314. doi: 10.1016/j.echo.2016.01.011.
- Ганелина И.Е., Липовецкий Б.М., Чурина С.К., и др. Атеросклероз венечных артерий и ишемическая болезни сердца. Руководство / Под ред. И.Е. Ганелиной. – 2-е изд., перераб. и доп. – СПб., 2012. – 320 с. [Ganelina IE, Lipovetskiy BM, Churina SK, et al. Ateroskleroz venechnykh arteriy i ishemicheskaya bolezni serdtsa. Rukovodstvo. Ed by I.E. Ganelinoy. 2nd ed. Saint Petersburg; 2012. 320 p. (In Russ.)]
- Fox K, Ford I, Steg PG, et al. Heart rate as a prognostic risk factor in patients with coronary artery disease and left-ventricular sistolic dysfunction (BEAUTIFUL): a subgroup analysis of a randomised controlled trial. Lancet. 2008;372:817-821. doi: 10.1016/S0140-6736(08)61171-X.
- Bohm M, Swedberg K, Komajda M, et al. Heart rate as a risk factor in chronic heart failure (SHIFT): the association between heart rate and outcomes in a randomised placebo-controlled trial. Lancet. 2010;376:886-894. doi: 10.1016/S0140-6736(10)61259-7.
- Сайганов С.А., Гришкин Ю.Н. Использование селективного ингибитора If-каналов ивабрадина для лечения синусовой тахикардии при острой сердечной недостаточности у больных ишемической болезнью сердца с нижним инфарктом миокарда //Кардиоваскулярная терапия и профилактика. – 2010. – Т. 9. – № 3. – С. 52–56. [Sayganov SA, Grishkin YuN. Ispol’zovanie selektivnogo ingibitora If-kanalov ivabradina dlya lecheniya sinusovoy takhikardii pri ostroy serdechnoy nedostatochnosti u bol’nykh ishemicheskoy bolezn’yu serdtsa s nizhnim infarktom miokarda. Kardiovaskulyarnaya terapiya i profilaktika. 2010;9(3):52-56. (In Russ.)]
- Martin R Cowie. Ivabradine: The Start of a SHIFT in Heart Failure Treatment. IntervCardiol. 2013;5(1):415-426.
- Kanorskij SG, Tregubov VG, Pokrovskij VM. Alternative treatment with invabradin in patients with CHF 3 functional class NYHA. Journal Cardiology. 2011:8.
- Сайганов С.А., Хурцилава О.Г., Хубулава Г.Г., и др. Влияние первичной коронарной баллонной ангиопластики на систолическую функцию левого желудочка у больных с острой сердечной недостаточностью и инфарктом миокарда с зубцом Q нижней локализации // Вестник хирургии им. И.И. Грекова. – 2010. – Т. 169. – № 1. – С. 33–38. [Sayganov SA, Khurtsilava OG, Khubulava GG, et al. Vliyanie pervichnoy koronarnoy ballonnoy angioplastiki na sistolicheskuyu funktsiyu levogo zheludochka u bol’nykh s ostroy serdechnoy nedostatochnost’yu i infarktom miokarda s zubtsom Q nizhney lokalizatsii. Vestnik khirurgii im. I.I. Grekova. 2010;169(1):33-38. (In Russ.)]
- Komajda M, Isnard R, Cohen-Solal A, et al. Effect of iva bradine in patients with heart failure with preserved ejection fraction: the EDIFY randomized placebo-controlled trial. Eur J Heart Fail. 2017 Apr 30. doi: 10.1002/ejhf.876.
- Сайганов С.А., Гомонова В.В. Клиническая оценка депрессии сегмента ST в грудных однополюсных отведениях у пациентов с нижним инфарктом миокарда // Ультразвуковая и функциональная диагностика. – 2010. – № 4. – С. 62–68. [Sayganov SA, Gomonova VV. Klinicheskaya otsenka depressii segmenta ST v grudnykh odnopolyusnykh otvedeniyakh u patsientov s nizhnim infarktom miokarda. Ul’trazvukovaya i funktsional’naya diagnostika. 2010;(4):62-68. (In Russ.)]
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