FEATURES OF LEFT VENTRICULAR REMODELING AND THE DEVELOPMENT OF CHRONIC HEART FAILURE IN PATIENTS WITH PRIOR MYOCARDIAL INFARCTION, TAKING INTO ACCOUNT THE MODE OF REVASCULARIZATION AND ADHERENCE TO THERAPY


A.I. Chesnikova (1), E.S. Godunko (1, 2), A.V. Khripun (1, 2), V.P. Terentev (1)

(1) Department of Internal Medicine with the basis of General Physiotherapy №1 SBEI HPE "Rostov State Medical University" of RMPH, Rostov-on-Don; (2) Regional Vascular Center SBI RR "Rostov Regional Clinical Hospital", Rostov-on-Don
The study was aimed to the evaluation of the structural and functional features of left ventricular remodeling and the development of chronic heart failure (CHF) in patients with myocardial infarction (MI) taking into account the mode of revascularization and adherence to therapy. At the hospital stage, all patients (n=101) were randomized to treatment groups according to a method of myocardial revascularization. Group 1 consisted of patients who underwent thrombolytic therapy (TLT), Group 2 – patients with percutaneous coronary intervention (PCI), the Group 3 – patients who did not undergo revascularization. At discharge from the hospital and 1 year after MI, the following examination was performed: echocardiography and Doppler echocardiography, a 6-minute walk test (6MWT), Rating Scale of Clinical State (RSCS), and evaluation of NT-proBNP levels. Adherence to the 5-component therapy (statins, two antiplatelets, renin-angiotensin-aldosterone system blockers, β-blockers) during the 1 year was assessed using Morisky-Green questionnaire. According to the results of study after one year of observation, it was revealed that PCI contributed to the improvement of the clinical manifestation, increased exercise tolerance, and had significant positive influence on echocardiography indicators, regardless of adherence to therapy. TLT therapy in acute myocardial infarction, with adherence to therapy, prevented further progression of CHF. In patients without myocardial reperfusion, signs of abnormal maladaptive left ventricular remodeling and higher NT-proBNP levels were revealed, indicating the progression of heart failure, particularly in patients without adherence to therapy.

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About the Autors


A.I. Chesnikova – Doctor of Medical Sciences, Prof. at the Department of Internal Medicine with the basis of General Physiotherapy №1 SBEI HPE "Rostov State Medical University" of RMPH, Rostov-on-Don; e-mail: rostov-ossn@yandex.ru
E.S. Godunko - external doctorate student at the Department of Internal Medicine with the basis of General Physiotherapy №1 SBEI HPE "Rostov State Medical University" of RMPH, Rostov-on-Don; physician at the Acute Cardiac Care Unit of the Regional Vascular Center SBI RR "Rostov Regional Clinical Hospital", Rostov-on-Don; e-mail: godunko@list.ru
A.V. Khripun – PhD in Medical Sciences, Teaching Assistant at the Department of Internal Medicine with the basis of General Physiotherapy №1 SBEI HPE "Rostov State Medical University" of RMPH, Rostov-on-Don, Director of the Regional Vascular Center SBI RR "Rostov Regional Clinical Hospital", Rostov-on-Don; e -mail: khripoun1@gmail.ru
V.P. Terentyev - Department of Internal Medicine with the basis of General Physiotherapy №1 SBEI HPE "Rostov State Medical University" of RMPH, Rostov-on-Don


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