Osobennosti remodelirovaniya levogo zheludochka i razvitiya khronicheskoy serdechnoy nedostatochnosti u bol'nykh, perenesshikh infarkt miokarda, s uchetom sposoba revaskulyarizatsii i priverzhennosti terapii

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.

NT-proBNP, thrombolytic therapy, percutaneous coronary intervention, chronic heart failure, left ventricular remodeling, NT-proBNP