Delayed Enhancement Cardiovascular Magnetic Resonance Imaging: the Role of Assessment of Contractile Function and Myocardial Viability of the Left Ventricle in Predicting Postoperative Dynamics in Patients with Ischemic Cardiomyopathy

Aim. Identify opportunities for cardiac MRI with contrast in predicting the dynamics of coronary artery disease after revascularization with pre-operative assessment morphological and functional state of LV in patients with ischemic cardiomyopathy (ICM). Material and methods. The study involved 28 people with ICM. After spiroveloergometry formed two groups of patients with improvement and deterioration of left ventricular function after revascularization. Before surgery, patients underwent MRI of the heart with the calculation of LV EDV and ESV and the proportion of viable LV myocardium. Comparing the values of these parameters in groups. Combined effects of functional performance and the percentage of viable myocardium in the postoperative prognosis LV estimates of multivariate discriminant analysis. Results. When the value of preoperative LV EDV 192 (186; 275) ml, LV ESV to 136 (124; 188) ml and the number of viable myocardium over 67 (59; 73) % LV mass a year after cardiovascular surgery should expect positive dynamics. When LV EDV more than 244 (209; 282) ml, LV ESV more than 187 (156; 215) ml and a content of less than viable myocardium 58 (52; 72) % in LV mass may imply the expression of remodeling and small opportunities myocardial reserve improve left ventricular function after cardiovascular surgery. Discriminant analysis formula Z = 0.56 · X (EDV) + 0.47 · X (ESV) - 0.54 · X (viab.) allows the calculation of index prediction Z, and get information about the type of dynamics of ICM after revascularization. Conclusions. With the help of cardiac MRI with contrast agent defined criteria for evaluating the state of LV morphology and function in patients with ICM, allowing preoperative examination to assess the possibility of myocardial reserve and predict the nature of ICM after revascularization.

МРТ, сердце, ишемическая кардиомиопатия, прогноз, cardiovascular MRI, ischemic cardiomyopathy, prediction

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