Myocardial perfusion in patients with pulmonary hypertension of different etiology

We included 59 PAH pts withangina-like symptoms: 28 pts (25 f/3m) with IPAH, 18 pts (14 f/4m) with congenital heart disease and 13 pts (12 f/1m) PAH associated with systemic scleroderma (SS), of comparable age: 36,86±11,5/44±17,47/46,32±15,71yrs respectively. On the 1st step of diagnostic examination we found the pts with ischemic changes on Holter ECG. In all pts with the identification of ischemic changes were performed single photon emission CT with 99mTc-MIBI myocardium at rest and on the peak of stress test.By Holter we identified the next change: in IPAH/PAH-CHD/PAH-SS group mean HR were 73,45±10,02/77,05±8,64/76±13,04 per min respectively. In IPAH group we observed ST depression by Holter ECG in 9 pts (32,1%), in PAH-CHD– 3 pts (16,6%), in PAH-SS 1 pts (7,7%). By single photon emission CT with 99mTc-MIBI PAH pts at rest revealed violations of myocardial perf LV and RV mainly RV (areas of fibrosis). PAH pts were characterized by diastolic LV dysfunction mainly and systolic RV dysfunction. Local perf defects and contractile LV dysfunction were moderate and often defined in the interventricular septum (IVS). Disorders of perf at rest in RV were more pronounced as compared to LV and were maximal in the IVS. The local hypokinesis of the RV free wall was more pronounced as compared to LV up to the maximal changes dyskinesia defined in the IVS. Ischemic changes on Holter ECG finding in PAH pts with angina-like symptoms require f...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: 4.3 Pulmonary Circulation and Pulmonary Vascular Disease Source Type: research