Evaluation of the antiischemic effect of a prolonged form of trimetazidine in patients with stable angina pectoris using speckle-tracking technique


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Abstract

Studies of global and segmental myocardial contractility using the speckle-tracking technique in patients suffering from stable angina pectoris compared to healthy individuals are presented. It was revealed that, in patients suffering from stable angina pectoris, the values of longitudinal deformation in the anterolateral and apical segments of the left ventricle, as well as global longitudinal deformation, decrease. Differences in longitudinal myocardial deformation in other segments were not observed in the subjects. Possible causes of a decrease in the longitudinal deformation of the myocardium, both in general and in individual segments of the left ventricle, are examined. The data on longitudinal segmental deformity of the left ventricle on the background of anti-ischemic therapy are presented. A direct correlation between the values of the global longitudinal deformation and the distance traveled by patients before the development of an angina attack was revealed.In addition, a direct correlation was found between the longitudinal deformation of the myocardium in the anterior septal region of the left ventricle and exercise tolerance. Adding a prolonged form of trimetazidine to complex anti-ischemic therapy leads to a significant increase in segmental and global deformity of the left ventricle, which is accompanied by a decrease in the daily need for nitroglycerin and an increase in exercise tolerance. The lack of dynamics of the longitudinal strain in the basal parts of the left ventricle during treatment may be due to the development of cardiosclerosis.

About the authors

A N Kuchmin

Военно-медицинская академия им. С.М. Кирова

Email: vmeda-nio@mil.ru
Санкт-Петербург

M Yu Yaroslavtsev

Военно-медицинская академия им. С.М. Кирова

Email: vmeda-nio@mil.ru
Санкт-Петербург

N V Afendikov

Военно-медицинская академия им. С.М. Кирова

Email: vmeda-nio@mil.ru
Санкт-Петербург

E P Galova

Военно-медицинская академия им. С.М. Кирова

Email: vmeda-nio@mil.ru
Санкт-Петербург

S N Shulenin

Военно-медицинская академия им. С.М. Кирова

Email: vmeda-nio@mil.ru
Санкт-Петербург

K B Evsyucov

Военно-медицинская академия им. С.М. Кирова

Email: vmeda-nio@mil.ru
Санкт-Петербург

A A Shevelev

Военно-медицинская академия им. С.М. Кирова

Email: vmeda-nio@mil.ru
Санкт-Петербург

References

  1. Юнкеров, В.И. Математико-статистическая обработка данных медицинских исследований / В.И. Юнкеров, С.Г. Григорьев, М.В. Резванцев. - СПб.: ВМА, 2011. - 318 с.
  2. Dahlslett, T. Early assessment of strain echocardiography can accurately exclude significant coronary artery stenosis in suspected non-ST-segment elevation acute coronary syndrome / T. Dahlslett [et al.] // Journal of the American Society of Echocardiography. - 2014. - Vol. 27. - Р. 512-519.
  3. Lang, R.M. Recommendations for Cardiac Chamber Quantifications by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging / R.M. Lang [et al.] // Journal of the American Society of Echocardiography: official publication of American Society of Echocardiography. - 2015. - Vol. 28 (1). - P. 1-39.
  4. Reisner, S.A. Global longitudinal strain: a novel index of left ventricular systolic function / S.A. Reisner [et al.] // Journal of the American Society of Echocardiography: official publication of American Society of Echocardiography. - 2004. - Vol. 17. - Р. 630-633. Рис. 3. 17-сегментная модель - система координат «Бычий глаз» пациента Д. до и при лечении триметазидином ВЕСТНИК РОССИЙСКОЙ ВОЕННО-МЕДИЦИНСКОЙ АКАДЕМИИ 1 (69) - 2020 21 Клинические исследования
  5. Rovner, A. Characterization of left ventricular diastolic function in hypertension by use of Doppler tissue imaging and color M-mode techniques / A. Rovner [et al.] // Journal of the American Society of Echocardiography: official publication of American Society of Echocardiography. - 2006. -Vol. 19. - Р. 872-879.
  6. Fragasso, G. Metabolic effects of cardiovascular drugs / G. Fragasso [et al.] // Trends in Cardiovascular Medicine. - 2019. - Vol. 29. - P. 176-187.
  7. Radico, F. Determinants of long-term clinical outcomes in patients with angina but without obstructive coronary artery disease: a systematic review and meta-analysis / F. Radico [et al.] // European Heart Journal. - 2018. - Vol. 39. - P. 2135-2146.
  8. Tomcsnyi, J. Effectiveness of trimetazidine prolong in stable coronary artery disease. multicenter, prospective, observational study, onecaps study / J.Tomcsnyi, S. Laszlo // Orv Hetil. - 2018. - Vol. 159. - P. 1549-1555.
  9. Ozan, D. Fractional flow reserve: current evidence base in stable coronary artery disease / D. Ozan [et al.] // Heart Metab. - 2019. - Vol. 79. - P. 9-12.
  10. Olímpio, R. Trimetazidine in the era of PCI / R. Olímpio, F. Neto // Heart Metab. - 2019. - Vol. 78. - P. 20-23.

Copyright (c) 2020 Kuchmin A.N., Yaroslavtsev M.Y., Afendikov N.V., Galova E.P., Shulenin S.N., Evsyucov K.B., Shevelev A.A.

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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