Dynamics of the myocardial structural and functional state in patients with non Q-wave myocardial infarction during 3 and 6 months follow-up in connection with percutaneous angioplasty
Aim. Assessment of the dynamics of the structural and functional state of the myocardium in patients with non Q-wave myocardial infarction in 3 and 6 months, depending on the percutaneous angioplasty performance.
Materials and Methods. We examined 77 patients (63.6% males) with non-Q myocardial infarction aged from 50 to 79 (mean 64.1±1.0) years. Hospital management routine was designed in accordance with modern standards for treatment of acute coronary syndrome without elevation of the ST segment, which envisaged the stratification of risk on the GRACE scale (estimated risk of mortality in the near future) and the choice of adequate procedure of the invasive strategy. The structural and functional state of the myocardium was evaluated using echocardiography, which was performed in the M-, B-, and D-modes.
Results and Discussion. More convincing positive hemodynamic changes were received in the group of patients treated surgically shown in the increase in the total score of the dynamics of echocardiographic parameters during 3 and 6 months follow-up in comparison with the group of drug therapy. At the same time, in the group of patients treated surgically, a significant increase in the total score of echocardiographic dynamics during 3 to 6 months follow-up was determined (p<0.001), whereas in the group of drug treatment this indicator did not show a significant increase during this period of observation (p=0,46).
Conclusions. Percutaneous angioplasty in patients with non-Q myocardial infarction, as compared to standard drug therapy, is accompanied by a more potent hemodynamic and anti-modulating effect during 3 and 6 months follow-up. The marked changes revealed a connection with the duration of treatment, which indicated an increase in the functional reserve of the myocardium after surgical revascularization.
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