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045-047
СБОРНИК ТЕЗИСОВ
045 EFFECT OF MICROVASCULAR INJURY VARIOUS TYPES ON LEFT VENTRICULAR DISORDERS BY ECHOCARDIOGRAPHY ON LONG-TERM PERIOD AFTER MYOCARDIAL INFARCTION WITH ST SEGMENT ELEVATION
Alekseeva Y. V.
Research Institute of Cardiology, Tomsk National Research Medical Center of the Russian Academy of Sciences; Siberian State Medical University, Tomsk, Russia
Aim. To analyze the long-term effect of microvascular injury various types on the parameters of the left ventricle assessed by echocardiography in patients with primary ST-segment elevation myocardial infarction (STEMI).
Material and methods. The study included 60 patients with primary STEMI admitted within the first 12 hours after the onset of disease who underwent stenting of the infarct-associated coronary artery. Exclusion criteria: pulmonary edema, cardiogenic shock, estimated glomerular filtration rate <30 mL/ min/1,73 m2 or dialysis, severe comorbidity, acute psychotic disorders and inability to undergo or contra-indications for CMR. Each patient included in the study underwent CMR imaging on the second day post-STEMI. MVO and IMH were assessed using late gadolinium enhancement and T2-weighted CMR imaging. Subsequently, all patients underwent the standard echocardiographic protocol on the 7th day and 3 months after MI. The study was registered at ClinicalTrials.gov, with identification number NCT03677466.
Results. IMH and MVO were revealed in majority of the patients with primary STEMI. We divided all patients into 4 groups: the 1st group didn't have any phenomena of IMH and MVO, the 2nd group had only MVO, patients of the 3rd group had only IMH and in the 4th group there was a combination of MVO and IMH. Patients with combination of MVO and IMH had significantly lower LV ejection fraction, if compared to those without it. Correlation analysis showed a moderate inverse correlation between the MVO area and LV contractile function: the larger the area, the lower the LVEF (R=-0,60; p=0,000002).
Conclusion. The combination of IMH and MVO is a predictor of a reduction in LVEF and an increase of volumetric measurements within 3 months after MI. In comparison with patients without microvascular injury isolated MVO is associated with lower LVEF. The size of MVO is directly correlated with the LV contractile function decrease. Isolated IMH was not associated with deterioration of left ventricular function.
046 EVALUATION OF HEMOGLOBIN CONFORMATION STATE IN PATIENTS WITH PULMONARY HYPERTENSION
Allakhverdiev E. S.1, Slatinskaya O. V.2, Rodnenkov O. V.1, Maksimov G. V.2,3, Martynyuk T. V.1
1National Medical Research Center of Cardiology, Department of pulmonary hypertension and heart diseases, Moscow; 2Lomonosov Moscow State University, Moscow; 3National Research Technological University "MISiS", Moscow, Russia
Currently, much attention is paid to the study of the molecular mechanisms of pulmonary hypertension formation. It is known that changes in the oxygen (O2) transport function of red blood cells (RBC) are caused not only by hemodynamics, but also by the conformation of hemoglobin (Hb), which determines the ability to bind and discharge O2.
The study of the molecular mechanisms of idiopathic pulmonary arterial hypertension (IPAH) is associated with new opportunities in assessing the severity of disease, therefore the conformation of hemoglobin (Hb) might be of special interest. The changes in the oxygen (O2) transport function of red blood cells (RBC) are caused not only by hemodynamics, but also by the conformation of Hb, which determines the ability to bind and discharge O2.
Aim. To study the oxygen transport function of RBC in patients with IPAH.
Material and methods. In the experimental study we performed resonance Raman spectroscopy (RRS) for diagnosing the conformation state of Hb of 10 patients (pts)who were hospitalized in the Department of pulmonary hypertension. The diagnosis of IPAH was confirmed by complex investigation including right heart catheterization (RHC). 10 healthy volunteers served as the control group (CG). Blood samples were taken from the cubital vein into vacuum tubes containing heparin. The ratio of the intensities of the bands of the Raman spectrum was analyzed. Statistical analysis of the results was carried out using the Friedman test followed by Dunn's post hoc analysis.
Results. Assessment the oxygen transport function in blood, namely, the differences in the conformation of RBC hemoporphyrin hemoglobin in the cubital vein of CG and patients with IpAh. It was found that the relative ability of Hb to release ligand (including O2 and NO), the number of deoxyHb complexes and the affinity of Hb for O2 was significantly different in the blood RBC (in plasma) cubital vein (CV) of a patient with confirmed IPH. Using Raman spectroscopy we also investigated the changes in the conformation of hemoporphyrin hemoglobin RBC incubated in phosphate buffer RBC in order to assess how plasma components affect the oxygen transport function of the RBC on the conformation of hemoporphyrin Hb in the (CV) of both group. IPAH patients were characterized by lower indicators of Hb ability to release O2 as compared with CG.
The conformation of Hb of RBC from the cubital vein In IPAH patients was characterized by the decreased ability of hemoglobin to shed ligands decreases, lower affinity of heme for O2, and the proportion of deoxyHb complexes increases;
Conclusion. In patients with IPAH with a typical hemodynamic picture, changes were revealed in the ability of hemoporphyrin of Hb to bind O2.
The conformation of Hb of RBC from the cubital vein in control group and IPAH patients was different, in IPAH patients was characterized by the decreased ability of hemoglobin to shed ligands, lower affinity of heme for O2, and the proportion of deoxyHb complexes.; The revealed changes in the structure of hemoporphyrin in patients with IPAH might help to develop the new diagnostic approaches for assessing the severity of the disease using the Raman spectroscopy method.
This study was supported by Russian Science Foundation (grant No:19-79-30062) for MGV, as well as the Interdisciplinary Scientific and Educational School of Moscow University "Molecular Technologies of Living Systems and Synthetic Biology".
047 DIAGNOSTIC VALUE OF PARAMETERS OF GLOBAL MYOCARDIAL WORK IN PATIENTS WITH STEMI
Babina A. V., Galimskaya V. A., Golubeva A. V., Oleynikov V. E.
Penza State University, Penza, Russia
Aim. To identify differences in the global parameters of left ventricular (LV) myocardial function in patients with preserved ejection fraction (EF) after STEMI and in healthy individuals.
Material and methods. The study included 45 people with primary STEMI: 8 women and 37 men aged 32 to 64 years (52,3±7,4). The control group (CG) consisted of 58 healthy volunteers with an average age of 47,7±7,7 years. Myocardial infarction was confirmed by ECG data, a diagnostically significant level of cardiospecific markers (troponin T, CK-MB) and by the results of coronary angiography with the presence of one infarct-related coronary artery in the absence of hemodynamically significant stenoses of other arteries. Echocardiographic examination was performed on 6-7 days after STEMI and 6 months after the onset of the disease on an ultrasound scanner of Vivid GE 95 Healthcare (USA). The analysis of echocardiographic images was performed using the EchoPAC software version 202 (GE Healthcare). Standard echoparameters were determined: end diastolic volume (EDV, ml), end systolic volume (ESV, ml), LV myocardial mass index (ILVM, g/m2), left ventricular relative wall thickness (RWT), EF by the Simpson biplane method. The value of this indicator was
Российский кардиологический журнал. 2021;26(S7), дополнительный выпуск (июнь)
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