[The role of interventricular septum in kinetics of left and right ventricular contraction in patients with ischemic heart disease and chronic cardiac failure].

AIM

To study the role of interventricular septum (IVS) in kinetics of left ventricular (LV) and right ventricular (RV) contraction in IHD patients with chronic cardiac failure (CCF).

MATERIAL AND METHODS

Standard equilibrium biventricular radioventriculography was used for the study of an inotropic function of LVand RV myocardium in 117 IHD patients with CCF of NYHA FC I-IV (mean age 58+/-4.1 years). Local myocardial contractility was studied with a unified 16-segment L V and RV model.

RESULTS

Segments, local ejection fraction (EF) of which exceeded 50% were considered as normokinetic, 25-50%--hypokinetic, under 25%--akinetic. Total EF of both ventricles in all patients with FCI-II CCF was normal being 63.6+/-4.6% in the left and 53.4+/-5.2% in the right ventricle. Alterations of segmental contractility as zones of hypo- and akinesia of primarily anteroseptal region of the ventricles were revealed. Patients with CCF of FC III had zones of interventricular septum (IVS) akinesia and hypokinesia of its free wall in lowering of LV EF to 43.2+/-6.3%. RV EF also decreased to 38.4+/-4.8%, IVS diskinesia zones appeared due to pulmonary hypertension. Patients with CCF of FC IV had LV EF of 15.1+/-4.1%, RV EF was 25.9 +/-6.8% with more definite disorders of segmentary contractility in the form of increased percentage of dys- and akinetic segments in the septal region and a free wall of both ventricles.

CONCLUSION

In IHD patients with initial CCF defects in local contractility occurred in IVS segments. With progression of CCF, lowering of total EF of both ventricles was associated with deterioration of local dysfunction in the form of increased proportion of hypo-, dys- and akinesia zones.