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A New Technique of Graphic Representation of Myocardial Reserve and Responsiveness of Peripheral Arteries when Choosing the Surgical Approach in Patients with Multifocal Atherosclerosis

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Author(s): L.N. Ivanov | V.G. Petrenko | V.V. Katynov | E.V. Yurasova | B.Е. Shakhov | А.P. Medvedev | А.L. Maksimov | О.Е. Loginov

Journal: Sovremennye Tehnologii v Medicine
ISSN 2076-4243

Volume: 5;
Issue: 2;
Start page: 53;
Date: 2013;
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Keywords: Concomitant lesions of coronary arteries and the arteries of lower extremities | Ejection fraction | Ankle brachial index | Staged or single-stage operations in multifocal atherosclerosis

ABSTRACT
The aim of the investigation was to develop a new technique to estimate myocardial and peripheral reserves; and on the basis of the obtained responsiveness indices of coronary and peripheral arteries — to improve the diagnostics and optimize the choice of surgical treatment modality of patients with multifocal atherosclerosis.Materials and Methods. 296 patients with concomitant lesions of coronary arteries and lower extremity vessels were examined. In 15 patients, according to the findings of synchronously performed stress-echocardiography and ultrasound Doppler of lower extremities, we compared the severity of coronary and peripheral syndromes using the developed technique of graphic representation of ejection fraction and ankle brachial index (initial, load-peak, recovery time 3 min, 6 min later) on phase plane.Results. The study of the distribution dynamics of the indices of ejection fraction and ankle brachial index — the basic indices of intracardiac regional circulatory dynamics — enabled to distinguish 4 zones: А1 zone — low coronary and satisfactory peripheral reserves, А2 zone — low coronary and peripheral reserves, А3 zone — low peripheral and satisfactory coronary reserves, B zone — satisfactory coronary and peripheral reserves. A surgical approach will depend on the zone the indices of the measured parameters are referred to.Conclusion. The suggested technique for the assessment of functional coronary and peripheral reserves by means of graphic representation of the findings on phase plane enables to specify the indications to surgical management and prognosticate ischemic complications.

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