Metabolism of fatty acids in left ventricle myocardium and the efficacy prognosis of cardio-resynchronizing therapy in dilated cardiomyopathy patients

Marina Olegovna Gulya, Yu B. Lishmanov, Konstantin Valerievich Zavadovsky, D. I. Lebedev

Результат исследований: Материалы для журналаСтатья

5 Цитирования (Scopus)

Выдержка

Aim. To study perfusion and metabolism of LV myocardium in patients with dilated cardiomyopathy (DCMP) and to invent on this basement a gamma-specific predictors for cardio-resynchronizing therapy (RT) efficacy. Material and methods. Totally 63 patients with DCMP included (41 male, 22 female) with mean age 55,4±8,3 y. o., having congestive heart failure (CHF) of III–IV NYHA. Before RT all patients underwent scintigraphy of myocardium with 99mÈ (for perfusion assessment) and 123I (for fatty acids metabolism). Before and in 6 months after RT all patients underwent echocardiography to assess intracardiac hemodynamics. Results. In 6 months after RT all patients were divided into two groups: 1) EDV LV decreased by ≥15% (n= 39) — “responders”, and 2) ESV LV decreased <15% (n=24) — “non-responders”. Before RT groups did not significantly differ by pumping function of the ventricle. Significant difference was found by following pre-operational scintigraphic parameters: perfusion defect (PD) (9,22±5,06% and 12,5±4,22%, p<0,01), metabolism defect on earlier pictures (MD) (9,21±5,42% and 11,27±5,39%, p<0,01). The equation of multiple regression was invented, which may prognose the dynamics of end-systolic volume after RT. By the ROC analysis data the main prognostic significance for RT has the size of metabolism defect area and calculated value of end-systolic volume dynamics. The best threshold MD=7,35% and it confirms the efficacy of RT with 77,8% sensitivity and 66,7% specificity. The best threshold value of calculated endsystolic volume dynamics — 34,02 confirms the 87,5% sensitivity and 100% specificity of RT. Conclusion. The data collected during metabolic myocardial gamma-scintigraphy may be used in the complex of methods that allow to predict the efficacy of cardioresynchronizing therapy.

Язык оригиналаАнглийский
Страницы (с-по)61-67
Число страниц7
ЖурналRussian Journal of Cardiology
Том113
Номер выпуска9
DOI
СостояниеОпубликовано - 1 янв 2014

Отпечаток

Dilated Cardiomyopathy
Heart Ventricles
Myocardium
Fatty Acids
Therapeutics
Perfusion
Myocardial Perfusion Imaging
Group Psychotherapy
ROC Curve
Radionuclide Imaging
Echocardiography
Heart Failure
Hemodynamics
Sensitivity and Specificity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Цитировать

Metabolism of fatty acids in left ventricle myocardium and the efficacy prognosis of cardio-resynchronizing therapy in dilated cardiomyopathy patients. / Gulya, Marina Olegovna; Lishmanov, Yu B.; Zavadovsky, Konstantin Valerievich; Lebedev, D. I.

В: Russian Journal of Cardiology, Том 113, № 9, 01.01.2014, стр. 61-67.

Результат исследований: Материалы для журналаСтатья

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abstract = "Aim. To study perfusion and metabolism of LV myocardium in patients with dilated cardiomyopathy (DCMP) and to invent on this basement a gamma-specific predictors for cardio-resynchronizing therapy (RT) efficacy. Material and methods. Totally 63 patients with DCMP included (41 male, 22 female) with mean age 55,4±8,3 y. o., having congestive heart failure (CHF) of III–IV NYHA. Before RT all patients underwent scintigraphy of myocardium with 99m{\`E} (for perfusion assessment) and 123I (for fatty acids metabolism). Before and in 6 months after RT all patients underwent echocardiography to assess intracardiac hemodynamics. Results. In 6 months after RT all patients were divided into two groups: 1) EDV LV decreased by ≥15{\%} (n= 39) — “responders”, and 2) ESV LV decreased <15{\%} (n=24) — “non-responders”. Before RT groups did not significantly differ by pumping function of the ventricle. Significant difference was found by following pre-operational scintigraphic parameters: perfusion defect (PD) (9,22±5,06{\%} and 12,5±4,22{\%}, p<0,01), metabolism defect on earlier pictures (MD) (9,21±5,42{\%} and 11,27±5,39{\%}, p<0,01). The equation of multiple regression was invented, which may prognose the dynamics of end-systolic volume after RT. By the ROC analysis data the main prognostic significance for RT has the size of metabolism defect area and calculated value of end-systolic volume dynamics. The best threshold MD=7,35{\%} and it confirms the efficacy of RT with 77,8{\%} sensitivity and 66,7{\%} specificity. The best threshold value of calculated endsystolic volume dynamics — 34,02 confirms the 87,5{\%} sensitivity and 100{\%} specificity of RT. Conclusion. The data collected during metabolic myocardial gamma-scintigraphy may be used in the complex of methods that allow to predict the efficacy of cardioresynchronizing therapy.",
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T1 - Metabolism of fatty acids in left ventricle myocardium and the efficacy prognosis of cardio-resynchronizing therapy in dilated cardiomyopathy patients

AU - Gulya, Marina Olegovna

AU - Lishmanov, Yu B.

AU - Zavadovsky, Konstantin Valerievich

AU - Lebedev, D. I.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Aim. To study perfusion and metabolism of LV myocardium in patients with dilated cardiomyopathy (DCMP) and to invent on this basement a gamma-specific predictors for cardio-resynchronizing therapy (RT) efficacy. Material and methods. Totally 63 patients with DCMP included (41 male, 22 female) with mean age 55,4±8,3 y. o., having congestive heart failure (CHF) of III–IV NYHA. Before RT all patients underwent scintigraphy of myocardium with 99mÈ (for perfusion assessment) and 123I (for fatty acids metabolism). Before and in 6 months after RT all patients underwent echocardiography to assess intracardiac hemodynamics. Results. In 6 months after RT all patients were divided into two groups: 1) EDV LV decreased by ≥15% (n= 39) — “responders”, and 2) ESV LV decreased <15% (n=24) — “non-responders”. Before RT groups did not significantly differ by pumping function of the ventricle. Significant difference was found by following pre-operational scintigraphic parameters: perfusion defect (PD) (9,22±5,06% and 12,5±4,22%, p<0,01), metabolism defect on earlier pictures (MD) (9,21±5,42% and 11,27±5,39%, p<0,01). The equation of multiple regression was invented, which may prognose the dynamics of end-systolic volume after RT. By the ROC analysis data the main prognostic significance for RT has the size of metabolism defect area and calculated value of end-systolic volume dynamics. The best threshold MD=7,35% and it confirms the efficacy of RT with 77,8% sensitivity and 66,7% specificity. The best threshold value of calculated endsystolic volume dynamics — 34,02 confirms the 87,5% sensitivity and 100% specificity of RT. Conclusion. The data collected during metabolic myocardial gamma-scintigraphy may be used in the complex of methods that allow to predict the efficacy of cardioresynchronizing therapy.

AB - Aim. To study perfusion and metabolism of LV myocardium in patients with dilated cardiomyopathy (DCMP) and to invent on this basement a gamma-specific predictors for cardio-resynchronizing therapy (RT) efficacy. Material and methods. Totally 63 patients with DCMP included (41 male, 22 female) with mean age 55,4±8,3 y. o., having congestive heart failure (CHF) of III–IV NYHA. Before RT all patients underwent scintigraphy of myocardium with 99mÈ (for perfusion assessment) and 123I (for fatty acids metabolism). Before and in 6 months after RT all patients underwent echocardiography to assess intracardiac hemodynamics. Results. In 6 months after RT all patients were divided into two groups: 1) EDV LV decreased by ≥15% (n= 39) — “responders”, and 2) ESV LV decreased <15% (n=24) — “non-responders”. Before RT groups did not significantly differ by pumping function of the ventricle. Significant difference was found by following pre-operational scintigraphic parameters: perfusion defect (PD) (9,22±5,06% and 12,5±4,22%, p<0,01), metabolism defect on earlier pictures (MD) (9,21±5,42% and 11,27±5,39%, p<0,01). The equation of multiple regression was invented, which may prognose the dynamics of end-systolic volume after RT. By the ROC analysis data the main prognostic significance for RT has the size of metabolism defect area and calculated value of end-systolic volume dynamics. The best threshold MD=7,35% and it confirms the efficacy of RT with 77,8% sensitivity and 66,7% specificity. The best threshold value of calculated endsystolic volume dynamics — 34,02 confirms the 87,5% sensitivity and 100% specificity of RT. Conclusion. The data collected during metabolic myocardial gamma-scintigraphy may be used in the complex of methods that allow to predict the efficacy of cardioresynchronizing therapy.

KW - Cardioresynchronizing therapy

KW - Dilated cardiomyopathy

KW - Scintigraphy of myocardium

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