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Full Reverse Left Ventricle Conteractility Function Remodeling and Recovery in Patient With Dilated Cardiomyopathy. Clinical Case

https://doi.org/10.18087/cardio.2023.12.n2256

Abstract

The article presents a clinical case of a patient with severe chronic heart failure of ischemic origin. In 2020, the patient with a long history of ischemic heart disease, as confirmed by clinical data and instrumental examination, was diagnosed with severe cardiomegaly and NYHA class III chronic heart failure. The course of heart failure was aggravated by the presence of arrhythmia in the form of atrial fibrillation. At the first stage, a drug therapy and lifestyle modifications were recommended. In 2021, a beneficial tendency in clinical and instrumental indexes was observed, which made it possible to move on to the surgical stage of treatment. A coronary artery bypass grafting was performed with ablation of the left atrial posterior wall using the “box lesion” technique. A follow-up examination performed a year later showed normalization of the left ventricular dimension and recovery of its contractile function. The symptoms of heart failure regressed to the level of NYHA functional class I; no relapses of atrial fibrillation were detected. The patient continues to receive recommended drug therapy.

About the Authors

S. A. Belyi
Pavlov First Saint-Petersburg State Medical University
Russian Federation

Candidate of Medical Sciences, St. Petersburg State Medical University named I.P. Pavlov, Research Institute of Surgery and Emergency Medicine, Center for Cardiovascular Surgery, senior researcher.

Saint-Petersburg, Russia



V. I. Lukashenko
Pavlov First Saint-Petersburg State Medical University
Russian Federation

Candidate of Medical Sciences, St. Petersburg State Medical University named I.P. Pavlov, Research Institute of Surgery and Emergency Medicine, surgeon, cardiac surgery department

Saint-Petersburg, Russia



A. V. Kriventsov
Pavlov First Saint-Petersburg State Medical University
Russian Federation

Head of Cardiac surgery department 

Saint-Petersburg, Russia



A. S. Nemkov
Pavlov First Saint-Petersburg State Medical University
Russian Federation

Professor, Phd

Saint-Petersburg, Russia



G. G. Khubulava
Pavlov First Saint-Petersburg State Medical University
Russian Federation

Academician of the Russian Academy of Sciences, Doctor of Medical Sciences, Professor, Chief Cardiac Surgeon of St. Petersburg and the North-Western District of the Russian Federation, Honored Doctor of the Russian Federation, St. Petersburg State Medical University named I.P. Pavlov, head of the faculty department of surgery with courses in laparoscopic and cardiovascular surgery.

Saint-Petersburg, Russia



References

1. Tereshchenko S.N., Galyavich A.S., Uskach T.M., Ageev F.T., Arutyunov G.P., Begrambekova Yu.L. et al. 2020 Clinical practice guidelines for Chronic heart failure. Russian Journal of Cardiology. 2020;25(11):311–74. DOI: 10.15829/1560-4071-2020-4083

2. Rush CJ, Berry C, Oldroyd KG, Rocchiccioli JP, Lindsay MM, Touyz RM et al. Prevalence of Coronary Artery Disease and Coronary Microvascular Dysfunction in Patients With Heart Failure With Preserved Ejection Fraction. JAMA Cardiology. 2021;6(10):1130–43. DOI: 10.1001/jamacardio.2021.1825

3. Rahimi G, Tecson KM, Elsaid O, McCullough PA. Role of Ischemic Heart Disease in Major Adverse Renal and Cardiac Events Among Individuals With Heart Failure With Preserved Ejection Fraction (from the TOPCAT Trial). The American Journal of Cardiology. 2021;142:91–6. DOI: 10.1016/j.amjcard.2020.11.034

4. Staszewsky L, Baviera M, Tettamanti M, Colacioppo P, Robusto F, D’Ettorre A et al. Insulin treatment in patients with diabetes mellitus and heart failure in the era of new antidiabetic medications. BMJ Open Diabetes Research & Care. 2022;10(2):e002708. DOI: 10.1136/bmjdrc-2021-002708

5. Tromp J, Ouwerkerk W, van Veldhuisen DJ, Hillege HL, Richards AM, van der Meer P et al. A Systematic Review and Network Meta-Analysis of Pharmacological Treatment of Heart Failure With Reduced Ejection Fraction. JACC: Heart Failure. 2022;10(2):73–84. DOI: 10.1016/j.jchf.2021.09.004


Review

For citations:


Belyi S.A., Lukashenko V.I., Kriventsov A.V., Nemkov A.S., Khubulava G.G. Full Reverse Left Ventricle Conteractility Function Remodeling and Recovery in Patient With Dilated Cardiomyopathy. Clinical Case. Kardiologiia. 2023;63(12):93-95. (In Russ.) https://doi.org/10.18087/cardio.2023.12.n2256

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ISSN 0022-9040 (Print)
ISSN 2412-5660 (Online)