ABSTRACT
We assessed character and extent of coronary vessels involvement in 27 patients with non ST-elevation acute coronary syndrome (NSTEACS) and compared angiography data with rheological properties of erythrocytes of patients and 30 practically healthy men. Stenoses of main branches of coronary vessels were found almost in 3/4 of cases. In 4 patients without stenoses in main branches of coronary arteries we revealed lowering of blood flow velocity related to small vessel disease (syndrome X). In 2 cases there were no changes in coronary circulation. Extent of vessel involvement was the least in patients with non Q-wave myocardial infarction as initial manifestation of ischemic heart disease and the greatest in patients with unstable angina after myocardial infarction. Patients with NSTEACS had elevated aggregation capacity and lowered deformability of erythrocytes. Degree of these changes did not depend on clinical peculiarities of development of the disease, extent of obstructions, character of vessels involvement. Positive correlation between was found content of cholesterol and degree of elevation of rate of erythrocyte aggregation.
Subject(s)
Acute Coronary Syndrome , Cholesterol/metabolism , Coronary Angiography , Erythrocyte Aggregation , Erythrocyte Deformability , Erythrocyte Membrane/metabolism , Acute Coronary Syndrome/blood , Acute Coronary Syndrome/diagnosis , Acute Coronary Syndrome/etiology , Acute Coronary Syndrome/physiopathology , Aged , Blood Viscosity , Coronary Stenosis/blood , Coronary Stenosis/complications , Coronary Stenosis/diagnosis , Coronary Stenosis/physiopathology , Electrocardiography , Humans , Male , Middle Aged , Severity of Illness IndexABSTRACT
The investigation included 56 patients with MI of lower localization and acute left ventricle failure (ALVF). Group A included 33 patients with primary coronary balloon angioplasty (PCBAP), in group B there were 23 patients with MI and ALVF without revascularization. Group A was divided into 2 subgroups--A1 (patients with history of IM) and A2 (patients without previous MI). On the first and on the 14th days echocardiographic investigation was performed in all the patients. Ejection fraction (EF) of the LV in dynamics by the 14th day of the disease increased in group A from 32.8 +/- 1.8% to 36.1 +/- 1.6% (p < 0.05) at the expense of subgroup A2 (32.1 +/- 2.6% on the first day and 37.5% +/- 1.9 on the 14th day, p < 0.05), while in subgroup A1 there were no substantial changes of EF. In group B, on the contrary, there was decreased EF of the LV. Most of the group A patients had many injuries of the coronary bed vessels. After PCBAP of the right coronary artery (RCA) the increase of EF was followed by an improvement of the local contractility of the LV myocardium not only in the infarction zone, but also in the segments with ischemic dysfunction in which blood flows from the infarction-independent artery with its collateral filling from RCA.
