[PP.14.36] LEFT VENTRICULAR HYPERTROPHY AND DIASTOLIC DYSFUNCTION FOR PROGNOSIS OF SUDDEN CARDIAC DEATH IN PATIENTS WITH MYOCARDIAL INFARCTION. (September 2017) - Leonova, I.
Abstract : Objective: Evaluation of left ventricular hypertrophy and dyastolic dysfunction as risk factors of sudden death (SCD) among patients with myocardial infarction (MI) Design and method: 300 pts. with MI was divided on two groups: 1 – pts. with increasing of ventricular mass index (LVMI) 208 pats., 2 – pts. with normal LVMI 92 pts. The used method were ECHO CG, arterial baroreflex sensitivity (ABS) and blood test, IL 1, beta, 6, TNF-alfa, CD 95 of lymphocytes. Results: The SCD rate at restrictive type of dyastolic dysfunction (DD) was (p = 0, 002) higher (16, 7%) compared with nonrestrictive DD (5, 0%) and at patients without DD (7, 5%). Ventricular arrhythmias at patients with the DD restrictive type met (p = 0, 004) more often (in 63%), versus non restrictive DD (35, 4%) and without DD (29, 1%). An ABS on 1-st day of MI was decreased; correlations between BS and DD (r = −0, 4, p < 0, 05), BS and left atrium size (r = −0, 4, p < 0, 05). At DD only authentic increasing level of CD95 of lymphocytes, (0, 44 ± 0, 3 * 109/l against 0, 34 ± 0, 2 * 109/l, p = 0, 01) was noted. The analysis of death has shown that in 1 group during the 1 year after MI 32 pts. have died, from them SCD - 26 (12, 5%), not suddenly - 6 pts. (2, 9%). In 2 group the death was observed at 5 pts: SCD 4 (4, 3%) and not SCD at 1 (1, 1%). The Cox analysis for SCD, at one-factorial model from 194 variables allocated LVH as a significant sign for SCD: relative risk −2, 2; 95% confidential intervals: 1, 09 - 8, 3; beta −1, 6; p = 0, 02. Conclusions: DD increased SCD risk at the account of interrelationship with such predictors as VA, lowering of sensitivity of cardiochronotropic component of ABS.