STRUCTURAL AND FUNCTIONAL FEATURES OF LEFT VENTRICLE IN PATIENTS WITH HEART FAILURE, CORONARY HEART DISEASE AND THYROTOXICOSIS

Abstract

Aim. This study was designed to determine the structural and functional features of left ventricle in patients with heart failure, coronary heart disease and thyrotoxicosis.Materials and methods. 85 patients aged 58.3±5.6 years were divided into 3 groups: the main one – 25 patients with coronary  heart disease (CHD), chronic heart failure (CHF) II-III functional  classes (FC) and thyrotoxicosis, average age –59.23±3.81; the 1st  comparison group – 30 patients with CHD and CHF FC II-III without  thyroid dysfunction, the average age – 57.6±2.73; the 2nd  comparison group – 30 patients with thyrotoxicosis without  concomitant cardiovascular diseases (CVD), the average age –  45.4±3.51. The structure and function of the thyroid gland were  examined in all patients. The echocardiographic (EchoCG)  examination was performed to evaluate the structural and functional  indicators of the left ventricle (LV).Results. The LV pathologic remodeling in patients of the main group is represented by two types: concentric left ventricle hypertrophy  (CLVH) and eccentric left ventricle hypertrophy (ELVH), CLVH was  more common than in patients without thyroid dysfunction but with  CHF and CHD (84.0%, р=0.01). The LV myocardium contractility  was reduced in patients of both groups with CHF, the values of the ejection fraction corresponded with the intermediate type of HF, there was no significant difference between the indices (p = 0.1).  The main group had significantly more pronounced decrease in the ratio of the blood flow velocity of early diastolic filling of the LV  and the maximal atrial systolic velocity (E / A) − 0.63 and the  increase in the isovolumic relaxation time (IVRT) – 84.69 ms in  comparison with the indicators of the CHD and CHF patients without thyroid dysfunction (p = 0.021, p = 0.034).Conclusion. For patients with CHF, CHD and thyrotoxicosis, predominance of LV remodeling according to the type of CLVH  (84.0% of cases) is typical as well as a moderate decrease in the  contractility of the LV and a more pronounced diastolic dysfunction.  It determines the structural and functional features of the left  ventricle in patients with CHF with this comorbidity.