PECULIARITIES OF MORPHO-FUNCTIONAL STATE OF THE MYOCARDIUM IN PATIENTS WITH UNSTABLE ANGINA DEPENDING ON SMOKING HABITS
DOI:
https://doi.org/10.11603/1811-2471.2020.v.i1.11084Keywords:
unstable angina, smoking, women, myocardial remodeling, myocardial contractilityAbstract
The article presents the results of a study of the structural and functional remodeling of the heart, the state of general and local myocardial contractility in women with unstable angina (UA), depending on the smoking habit.
The aim – to study the features of structural and functional cardiac remodeling, the state of general and local myocardial contractility in women with unstable angina (UA) depending on smoking habits.
Material and Methods. A total of 146 women aged 38–73 years (mean age (54.63±1.45) hospitalized for UA were examined. In dependence on smoking habits all patients were divided into two groups: group 1 – female smokers (n = 82, the average age of (50.7±1.8) years). Group 2 – women with UA, without habits of smoking (n = 64, mean age (59.8±1.4). years). After carrying out of transthoracic echocardiography during the first day of hospitalization it was found out the End-Diastolic Size of the left ventricle (LVEDS, cm), the End-Systolic Size (LVESS, cm), the Posterior Wall Thickness (PWT, cm) and Septal wall thickness (SWT, cm) of the left ventricle LV, left atrium size (LAS, cm), the LV end-diastolic volume (LVEDV, ml ), the LV end-systolic volume (LVESV, ml ) and the LV ejection fraction (LVEF), degree of violation of local contractility (DVLC ) and asynergy index ( IndA ).
Results. The average age of women smokers hospitalized with UA (group I) was approximately 9 years significantly lower than the non-smokers (group II). Compared with the patients in group II, patients in group I have significantly higher results of LVEDS ( 5.75±0.04) (I) vs. (4.43±0.05) cm (II)), LVESS (4.29±0.26) (I) vs. (3.84±0.21) cm (II)), LVESV (80.54±10.07) (I) vs. (56.96±7.82) ml (II)), LVEDV (148.15±13.40) (I) and (134.28±12.74) ml (II)), LAS (3.82±0.06) (I) vs. (3.45±0.06) cm (II)), PWT (1.04±0.01) (I) vs. (0.97±0.03) cm (II)) and SWT (1.18±0.01) vs. (1.12±0.02) cm (II)), LV mass (LVM) (172.52±9.82) (I) vs. (161.45±7.26) (II)) and LV mass index (LVMI) (112.43±3.56) (I) vs. (97.12±2.93) g/m 2 (II)). In patients with smoking factor (group I) predominantly eccentric hypertrophy of the left ventricle (47.6 %) is formed, in women in group II – is formed concentric remodeling of LV (43.7 %). The average value of the LVEF in individuals of group I turned to be significantly lower and the data of the level of regional myocardial contractility (DVLC and IndA) – higher than women in group II had (1.06±0.01) units and (1.25±0.01) (I) vs (0.67±0.02) and (1.14±0.02) (II).
Conclusions. Factor of smoking is associated with the development of distinct structural and functional changes in the myocardium of women and higher risk of acute coronary syndrome (ACS) in significantly younger ages. It is recordered that patients with UA and factor of smoking, compared to nonsmokers, have significantly larger LA and thickening of the walls of the LV, increasing of the ESV and the EDV of the LV, LVMI and forming mainly eccentric hypertrophy. In women smokers with UA was found heavier violation of general and regional myocardial contractility than women without the habit of smoking, as evidenced by significantly lower LVEF and higher values IndA and DVLC.
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