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Скорости кровотока в дистальном сегменте передней нисходящей коронарной артерии у больных ишемической и дилатационной кардиомиопатией

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Целью сообщения явилась оценка скоростей кровотока в проксимальном и дистальном сегментах передней нисходящей артерии во время систолы и диастолы у больных ишемической и дилатационной кардиомиопатией. В анализ включены 23 пациента с ишемической и 10 пациентов с дилатационной кардиомиопатией в возрасте от 35 до 65 лет с сердечной недостаточностью (функциональный класс III–IV). Проксимальный и дистальный сегменты передней нисходящей артерии визуализированы из модифицированной апикальной позиции. Определяли интеграл скорости (VTI), максимальную (Vmax) и среднюю (Vmn) скорости кровотока в периоды систолы и диастолы, отношение скоростей во время диастолы к скоростям во время систолы (Vmax diast/Vmax syst и Vmn diast/Vmn syst). При ишемической кардиомиопатии значения отношения Vmax diast/Vmax syst в дистальном сегменте передней нисходящей артерии были 2,0, а Vmn diast/Vmn syst – 1,8. Чувствительность, специфичность и диагностическая точность данных критериев в выявлении ишемической кардиомиопатии составили 70,8, 100,0 и 81,8% и 82,6, 100,0 и 90,6% соответственно.

Ключевые слова:
трансторакальная допплерэхокардиография, коронарный кровоток, дилатационная кардиомиопатия, ишемическая кардиомиопатия, стеноз коронарных артерий.

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The Blood Velocity in the Distal Segment of the Anterior Descending Coronary Artery in Patients with Ischemic and Dilated Cardiomyopathy

The aim of the study was to estimate the blood flow velocity in the proximal and distal segments of anterior descending artery during systole and diastole in patients with ischemic and dilated cardiomyopathy. 23 patients with ischemic and 10 patients with dilated cardiomyopathy aged from 35 up to 65 years old with heart failure (NYHA III–IV) were included in the research. The proximal and distal segments of anterior descending artery were visualized from a modified apical position. Velocity time integral (VTI), maximal velocity (Vmax) and mean velocity (Vmn) of blood flow during systole and diastole, ratio of the velocity during diastole to velocity during systole (Vmax diast/Vmax syst and Vmn diast/Vmn syst) were calculated. In patients with ischemic cardiomyopathy the Vmax diast/Vmax syst in distal segment of anterior descending artery was 2.0 and Vmn diast/Vmn syst was 1.8. The sensitivity, specificity, and diagnostic accuracy for Vmax diast/Vmax syst were 70.8, 100.0, and 81.8%, for Vmn diast/Vmn syst – 82.6, 100.0, and 90.6%.

Keywords:
transthoracic Doppler echocardiography, coronary blood flow, dilated cardiomyopathy, ischemic cardiomyopathy, and coronary artery stenosis.