Saratov JOURNAL of Medical and Scientific Research
Home

The effect of elective percutaneous coronary intervention on clinical and echocardiographic parameters of patients with heart failure with mildly reduced ejection fraction

Year: 2022, volume 18 Issue: №2 Pages: 227-233
Heading: Cardiology Article type: Original article
Authors: Kulbaisova S.A., Galin P.Yu.
Organization: Orenburg State Medical University
Summary:

Objective: to assess the annual dynamics of clinical, laboratory and echocardiographic characteristics of patients with heart failure with mildly reduced ejection fraction after elective percutaneous coronary intervention. Material and methods. The study involved 101 patients (16 women and 85 men) with signs of chronic heart failure and ejection fraction 40-49%. The examination included scoring on the clinical condition assessment scale, six-minute walk test, determination of N-terminal prohormone of brain natriuretic peptide (NT-proBNP, pg/ml), transthoracic echocardiogra-phy. Mean age is 59±9 years. The distribution by functional classes of heart failure was as follows: I — 1%, II —63.4%, ill — 33.7%, IV — 2%. Results. After 12 months the number of points on the clinical condition assessment scale decreased from 3 (2; 4) to 1 (0; 1) points (p<0.001) mainly due to a decrease in dyspnea. The increase in distance in the six-minute walk test over 12 months was 85 (57; 115) meters (p<0.001). Mean NT-proBNP level in the group decreased from 370 (295; 459) to 264 (193; 343) pg/ml (p <0.001). Over the year, mean increase in the ejection fraction was 7±5% (p<0.001). Conclusion. Elective percutaneous coronary intervention has a positive effect on the annual dynamics of clinical, laboratory and echocardiographic parameters of patients with heart failure with mildly reduced ejection fraction.

Keywords: mildly reduced left ventricular ejection fraction, percutaneous coronary intervention

Bibliography:
1. Polyakov DS, Fomin IV, Belenkov YuN, et al. Chronic heart failure in the Russian Federation: what has changed over 20 years of follow-up? Results of the EPOCH — CHF study. Kardiologiia 2021; 61 (4): 4-14.
2. Ageev FT, Ovchinnikov AG. Heart failure with mid-range ejection fraction: are there clinical reasons in introduction of this new group as a distinct entity? Kardiologiia 2018; 58 (12S): 4-10.
3. McDonagh ТА, Metra М, Adamo М, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2021; 42 (36): 3599-726. DOI: 10.1093/eurheartj/ehab368.
4. Gaudino M, Hameed I, Khan FM, et al. Treatment strategies in ischaemic left ventricular dysfunction: A network meta-analysis. Eur J Cardiothorac Surg 2021; 59 (2): 293-301. DOI: 10.1093/ejcts/ezaa319.
5. Abudukeremu N, Yu ZX, Yang YN, et al. An Updated Systematic review and meta-analysis of the short- and long-term outcomes of percutaneous coronary intervention for patients with severe left ventricular systolic dysfunction. J Cardiovasc Med Cardiol 2018; 5 (4): 73-80. DOI: 10.17352/2455-2976.000076.
6. Mareev VYu, Fomin IV, Ageev FT, et al. Russian Heart Failure Society, Russian Society of Cardiology. Russian Scientific Medical Society of Internal Medicine Guidelines for Heart failure: chronic (CHF) and acute decompensated (ADHF). Diagnosis, prevention and treatment. Kardiologiia 2018; 58 (S6): 8-158.
7. American Thoracic Society. Committee on proficiency standards for clinical pulmonary function laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002; 166(1): 111-7.
8. Taylor RS, Walker S, Ciani O, et al. Exercise-based cardiac rehabilitation for chronic heart failure: the EXTRAMATCH II individual participant data meta-analysis. Health Technol Assess 2019; (23): 1-98. DOI: 10.3310/hta23250.
9. Harrington D, Anker SD, Chua TP, et al. Skeletal muscle function and its relation to exercise tolerance in chronic heart failure. J Am Coll Cardiol 1997; 30 (7): 1758-64. DOI: 10.1016/S0735-1097(97)00381 -1.
10. Kitzman DW, Whellan DJ, Duncan P, et al. Physical rehabilitation for older patients hospitalized for heart failure. N Engl J Med 2021; 385 (3): 203-16. DOI: 10.1056/NEJMoa2026141.
11. Ezekowitz JA, O'Meara E, McDonald MA, et al. Comprehensive update of the Canadian Cardiovascular Society guidelines for the management of heart failure. Can J Cardiol 2017; 33 (11): 1342-433. DOI: 10.1016/j.cjca.2017.08.022.
12. Rizzello V, Poldermans D, Biagini E, et al. Relation of improvement in left ventricular ejection fraction versus improvement in heart failure symptoms after coronary revascularization in patients with ischemic cardiomyopathy Am J Cardiol 2005; 96 (3): 386-89. DOI: 10.1016/j.amjcard. 2005.03.082.
13. Schinkel AF, Poldermans D, Rizzello V, et al. Why do patients with ischemic cardiomyopathy and a substantial amount of viable myocardium not always recover in function after revascularization? J Thorac Cardiovasc Surg 2004; 127 (2): 385-90. DOI: 10.1016/j.jtcvs.2003.08.005.

AttachmentSize
2022_2_227-233.pdf448.44 KB
All articles of the authors: Galin PYu, Kulbaisova SA

No votes yet