P403Viable myocardium in patients with left ventricular aneurysm

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Objective of the study was to assess viable myocardium in patients with left ventricular aneurysm, according to myocardial perfusion scintigraphy with Tc 99m - technetril.

Material and methods: 64 patients aged from 45 to 65 years (mean age 52 ± 12,5), 61 males and 1 female were examined in the Republican Specialized Center of Surgery named after academician V. Vokhidov in the department of coronary surgery of ischemic heart disease with myocardial infarction, complicated by left ventricular aneurysm. For the assessment of hibernating myocardium all patients underwent myocardial perfusion scintigraphy with Tc 99m - technetril with "rest - tilt test" protocol. We studied the local violations of perfusion and left ventricular contractility using a 16-segment model of the left ventricle.

The results of the study: We analyzed 1024 segments, where in rest there were 347 (30%) of the segments with the absence of perfusion, 553 (54%) ones had normal perfusion, and 124 (16%) of segments marked hypoperfusion. After tilt test, the increased accumulation of Tc 99m occurred in 104 segments while 243 segments were lack of perfusion (p < 0.024). Due to contractile function we found that in rest 522 (51%) of segments had normal contractility, violation of local inotropic functions was in 502 (49%) analyzed sectors, of which 358 (35%) had myocardial akinetic segments and 144 (14 %) were hypokinetic. In response to tilt test myocardium contractility improved in the 129 initially akinetic segments (p <0.048). As a result, the total number of akinetic sectors was 229, and the normal contractility had 563 segments.

Conclusion: According to our survey the number of segments with a lack of perfusion decreased by 13%, which accompanied by a reduction in the number of akinetic areas. That proves the viable myocardium in patients with left ventricular aneurysm.

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