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[Effect of stress-limiting factors on characteristics of intracardial hemodynamics in patients with early cardiac insufficiency].

Effects of stress-limiting factors on intracardiac hemodynamics at early stages of heart failure were evaluated in 71 patients aged 50.7 +/- 1.4 years with coronary heart disease (CHD) of NYHA functional class I-II. Based on the results of echocardiography, the patients were divided into 3 groups, viz. SDF group (n = 23) with left ventricular (LV) systolic dysfunction (ejection fraction (EF) < 45%), DDF group (n = 22) with LV diastolic dysfunction (E/A < 1.0 at EF > 45%), and control group (n = 26) (EF > 45%, E/A > 1.0). Parameters of intracardiac hemodynamics were assessed at muscular relaxation and in the image visualization test intended to improve the heart pump function. Either test revealed a 11.9% and 14.3% increase of LV EF respectively in patients of the SDF group compared with its initial value (p < 0.05). LV filling parameters in these tests remained unaltered. The E/A ratio in the DDF group increased from 0.91 +/- 0.05 to 0.97 +/- 0.05 at muscular relaxation and to 0.99 +/- 0.05 in the image visualization test (p < 0.05 in both cases). These changes were unaccompanied by variation of intraventricular filling and might be due to decreased afterload. Parameters of LV systolic function in this group did not appreciably change in either test. It is concluded that stress-limiting factors examined in this study improved intracardiac hemodynamic characteristics in patients at early stages of chronic heart failure. This suggests that they may be of value for combined therapy of these patients.