Heart remodeling in patients with acute Q-wave myocardial infarction in the presence of left bundle branch block

被引:0
作者
Syvolap, V. D. [1 ,2 ]
Zemlyaniy, Ya. V. [3 ]
机构
[1] Zaporizhzhia State Med Univ, Zaporizhia, Ukraine
[2] Zaporizhzhia State Med Univ, Dept Internal Med 1, Zaporizhia, Ukraine
[3] Zaporizhzhia State Med Univ, Dept Internal Dis 1, Zaporizhia, Ukraine
关键词
ventricular remodeling; bundle-branch block; myocardial infarction;
D O I
10.14739/2310-1210.2018.3.130847
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The aim - to evaluate the structural and functional features of the heart in patients with acute Q-wave myocardial infarction in the presence of left bundle branch block. Materials and methods. The study involved 60 patients with Q-MI (40 men and 20 women), who were hospitalized in cardiology department for patients with myocardial infarction treatment of Zaporizhzh.a City Emergency and Urgent Care Clinic. Patients were divided into two groups: 40 patients with Q-MI and the LBBB (the mean age was 71.53 +/- 1.23 years), 20 patients with Q-MI without LBBB (the mean age was 65.47 +/- 2.25 years). Assessment of intracardiac hemodynamics were performed by echocardiography using a "MyLab50" ("Esaote", Italy) ultrasound system on the recommendations of the American Society of Echocardiography. Results. Patients with acute Q-MI with LBBB were significantly older than patients who had acute Q-MI without LBBB (9.2 %, P < 0.05). Patients with anterior acute Q-MI prevailed among persons with LBBB (75 %). Thickening of the posterior wall (by 9.6 %; P < 0.05), an increase in LVMMI (by 11.2 %; P < 0.05), an increase in end-diastolic size (by 12.9 %; P < 0.05) and end-systolic size (by 18.6 %; P < 0.05); acceleration of MVE (by 18.3 %; P < 0.05); and an increase systolic pressure in the pulmonary artery (by 23.1 %; P < 0.05) were found in patients with Q-MI with LBBB compared to patients with Q-MI without LBBB. The analysis of contingency table revealed significant association between LBBB presence in patients with Q-MI and diabetes mellitus (X-2 = 4.53; P < 0.05), female gender (X-2 = 3.87; P < 0.05) and age over 65 years (X-2 = 5.71; P < 0.05). In patients with acute Q-MI and LBBB a significant positive correlation between the QRS width and end-diastolic size (+0.49; P < 0.05), end-systolic size (+0.45; P < 0.05), systolic pressure in pulmonary artery (+0.31; P < 0.05) and diastolic size of right ventricle (+0.38; P < 0.05), and a negative correlation between the QRS width and ejection fraction (- 0.71; P < 0.05) and IVRT (-0.37; P < 0.05) were noted. Conclusions. LBBB in patients with acute Q-MI is associated with female gender, age over 65 years and past history of diabetes mellitus. Acute Q-MI in the presence of LBBB is characterized by eccentric hypertrophy with an increase in the left ventricular size and pulmonary hypertension. QRS complex duration in patients with acute Q-MI and LBBB is associated with systolic function deterioration, left ventricular dilatation and pulmonary hypertension.
引用
收藏
页码:319 / 323
页数:5
相关论文
共 13 条
[1]  
Amsterdam EA, 2014, J AM COLL CARDIOL, V64, P2645, DOI [10.1016/j.jacc.2014.09.016, 10.1016/j.jacc.2014.09.017]
[2]  
CABRERA E, 1953, Arch Inst Cardiol Mex, V23, P441
[3]   QRS Duration Is Associated With Atrial Fibrillation in Patients With Left Ventricular Dysfunction [J].
El-Chami, Mikhael F. ;
Brancato, Candace ;
Langberg, Jonathan ;
Delurgio, David B. ;
Bush, Heather ;
Brosius, Lynne ;
Leon, Angel R. .
CLINICAL CARDIOLOGY, 2010, 33 (03) :132-138
[4]   Left bundle-branch block - Pathophysiology, prognosis, and clinical management [J].
Francia, Pietro ;
Balla, Cristina ;
Paneni, Francesco ;
Volpe, Massimo .
CLINICAL CARDIOLOGY, 2007, 30 (03) :110-115
[5]  
Kovalenko V. I., 2016, SERT SEVO SUDYNNI ZA
[6]   Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging [J].
Lang, Roberto M. ;
Badano, Luigi P. ;
Mor-Avi, Victor ;
Afilalo, Jonathan ;
Armstrong, Anderson ;
Ernande, Laura ;
Flachskampf, Frank A. ;
Foster, Elyse ;
Goldstein, Steven A. ;
Kuznetsova, Tatiana ;
Lancellotti, Patrizio ;
Muraru, Denisa ;
Picard, Michael H. ;
Rietzschel, Ernst R. ;
Rudski, Lawrence ;
Spencer, Kirk T. ;
Tsang, Wendy ;
Voigt, Jens-Uwe .
EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, 2015, 16 (03) :233-271
[7]   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].
Nagueh, Sherif F. ;
Smiseth, Otto A. ;
Appleton, Christopher P. ;
Byrd, Benjamin F., III ;
Dokainish, Hisham ;
Edvardsen, Thor ;
Flachskampf, Frank A. ;
Gillebert, Thierry C. ;
Klein, Allan L. ;
Lancellotti, Patrizio ;
Marino, Paolo ;
Oh, Jae K. ;
Popescu, Bogdan Alexandru ;
Waggoner, Alan D. .
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, 2016, 29 (04) :277-314
[8]  
Revishvili A. Sh., 2007, VESTNIK ARITMOLOGII, V48, P47
[9]   2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC) [J].
Roffi, Marco ;
Patrono, Carlo ;
Collet, Jean-Philippe ;
Mueller, Christian ;
Valgimigli, Marco ;
Andreotti, Felicita ;
Bax, Jeroen J. ;
Borger, Michael A. ;
Brotons, Carlos ;
Chew, Derek P. ;
Gencer, Baris ;
Hasenfuss, Gerd ;
Kjeldsen, Keld ;
Lancellotti, Patrizio ;
Landmesser, Ulf ;
Mehilli, Julinda ;
Mukherjee, Debabrata ;
Storey, Robert F. ;
Windecker, Stephan ;
Baumgartner, Helmut ;
Gaemperli, Oliver ;
Achenbach, Stephan ;
Agewall, Stefan ;
Badimon, Lina ;
Baigent, Colin ;
Bueno, Hector ;
Bugiardini, Raffaele ;
Carerj, Scipione ;
Casselman, Filip ;
Cuisset, Thomas ;
Erol, Cetin ;
Fitzsimons, Donna ;
Halle, Martin ;
Hamm, Christian ;
Hildick-Smith, David ;
Huber, Kurt ;
Iliodromitis, Efstathios ;
James, Stefan ;
Lewis, Basil S. ;
Lip, Gregory Y. H. ;
Piepoli, Massimo F. ;
Richter, Dimitrios ;
Rosemann, Thomas ;
Sechtem, Udo ;
Steg, Ph. Gabriel ;
Vrints, Christian ;
Zamorano, Jose Luis .
EUROPEAN HEART JOURNAL, 2016, 37 (03) :267-+
[10]   COMPARATIVE FEATURES OF NEWLY ACQUIRED LEFT AND RIGHT BUNDLE-BRANCH BLOCK IN THE GENERAL-POPULATION - THE FRAMINGHAM-STUDY [J].
SCHNEIDER, JF ;
THOMAS, HE ;
SORLIE, P ;
KREGER, BE ;
MCNAMARA, PM ;
KANNEL, WB .
AMERICAN JOURNAL OF CARDIOLOGY, 1981, 47 (04) :931-940