GEOMETRIC HEART REMODELING IN PATIENTS WITH CORONARY ARTERY DISEASE, AFTER REVASCULARIZATION
Keywords:
coronary heart disease, revascularization, echocardiography, myocardial remodeling, sacubitrilAbstract
Purpose of the study: to study the effect of the combination of valsartan with sacubitril on myocardial remodeling in patients with coronary heart disease after revascularization.
Material and research methods. The study included 320 patients with coronary artery disease who underwent coronary revascularization. On average, the concentration of creatinine was 90.08 ± 1.72 µmol / L. All patients were divided into 2 groups: patients who received valsartan (group B, 160 people), patients who received ARNI - a combination of valsartan and sacubitrile molecules (group C, 160 people). Also, all patients were divided into 2 subgroups depending on the degree of eGFR decrease by the 3rd month of observation: patients with a decrease in eGFR by the 3rd month of observation more than 20% (group 1 - 59 patients) and less than 20% (group 2 - 261 sick). In dynamics, three months later, at the end of the first and second years of follow-up after revascularization, all patients underwent an echocardiographic study (EchoCG).
Research results. During the observation process, it was found that against the background of both therapy options, there was a positive dynamics of indicators characterizing myocardial remodeling. he relative dynamics of indicators between the treatment groups was comparable at all stages of observation. In the group of patients with a decrease in eGFR of more than 20% in the first 3 months against the background of standard therapy after revascularization, no significant dynamics of the geometric parameters of the heart was observed at all follow-up periods. In the group of patients who received standard therapy with the addition of sacubitrile, both in group 1 and in group 2, more favorable geometric parameters were achieved, demonstrating a decrease in the severity of pathological remodeling and the formation of CHF.
Conclusion. The use of sacubitril in the treatment of patients with coronary artery disease contributes to a more pronounced positive remodeling of the heart chambers - a decrease in the size of the chambers and the LV sphericity index. The effect is more pronounced in patients with a tendency to rapidly develop CKD.
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