[Significance of papillary muscle function of the mitral valve and adjacent left ventricular segments in the progression of ischemic mitral regurgitation in patients with coronary heart disease after surgical treatment].

Aim: To determine the significance of papillary muscle (PM) dysfunction of the mitral valve (MV) and adjacent left ventricular (LV) segments in the genesis of ischemic mitral regurgitation (MR) by myocardial tissue Doppler (MTD) in patients with coronary heart disease (CHD) after surgical treatment.

Subjects And Methods: One hundred and one CHD patients with moderate (grade I-II) MR were examined before surgical treatment. For analysis, the patients were divided into 4 groups: 1A) 40 patients without progressive, none or moderate MR after isolated aortocoronary bypass surgery (ACBS); 1B) 17 patients with progressive MR to its clinically relevant degree after isolated ACBS; 2A) 30 patients without progressive, none, or moderate MR after ACBS and surgical repair of postinfarction LV aneurysm; 2B) 14 patents with progressive MR to its clinically relevant degree after ACBS and surgical LV repair.

[Prognostic factors for progression of mitral regurgitation in patients with coronary heart disease after aortocoronary bypass surgery alone and in combination with surgical left ventricular reconstruction].

Aim: To identify risk and prognostic factors for mitral regurgitation (MR) progression after aortocoronary bypass surgery (ACBS) alone and in combination with surgical left ventricular (LV) reconstruction.

Subjects And Methods: Data on 101 patients with coronary heart disease who had undergone surgical treatment: ACBS alone in 57 (56%) patients and that in combination with surgical LV reconstruction in 44 (44%).

Results: In the late periods after ACBS alone, there was reduced or no MR in 18% of the patients; no substantial changes in MR in 52%, the latter being moderate; progression to significant mitral insufficiency (MI) in 30%.

[Interrelationship between functional state of the right ventricle and severity of heart failure in patients with ischemic heart disease and depressed left ventricular function].

Dobutamine Doppler echocardiography was carried out in 56 patients (n=56) with ischemic heart disease and depressed left ventricular function (left ventricular ejection fraction <40%) and chronic heart failure. Clinical signs of heart failure were moderate (NYHA class I-II) in 34 and severe (NYHA class III-IV) in 22 patients. Patients with moderate and severe clinical heart failure had similar degree of left ventricular myocardium impairment however those with severe symptoms had more pronounced right ventricular (RV) dysfunction (greater suppression of global and local RV contractility, greater percentage of irreversibly dysfunctional RV myocardium, lower RV contractile response to dobutamine infusion, more pronounced disturbances of RV diastolic filling).

[Sigmental right ventricular contractile function in patients with ischemic heart disease].

Segmental right ventricular function was assessed by dobutamine stress echocardiography in 101 patients with ischemic heart disease and multiple coronary artery lesions. At rest local wall motion abnormalities were found in 69% of patients. Overall 505 segments of the right ventricle were analyzed (5 per patient).