THE PROCESS OF COMBINED INFERIOR MYOCARDIAL INFARCTION AND RIGHT VENTRICLE MYOCARDIAL INFARCTION WITH TRANSIENT ARTERIAL HYPOTENSION

Aim. To study the arterial hypotension influence to the progress of combined inferior and right ventricle myocardial infarction.

Material and methods. There were studied 66 patients with the primary inferior and right ventricle myocardial infarction. Patients were divided into 2 groups: 1st group - patients with inferior and right ventricle myocardial infarction with stable hemodynamics (n=34); 2nd group - patients with inferior and right ventricle myocardial infarction complicated by arterial hypotension in early period (n=32). Electrocardiography (ECG) and echocardiography (EchoCG) were performed in patients 1, 3, 30 days and 6 months after.

Results. On the 6th month of the disease, despite adequate conservative therapy, there was a significant increase of LV volume index in patients from the 2nd group, thus EDV LV was 164.2±4.2 ml³, ESV 94.1±2.8 ml³ (p<0.028). It was positive dynamics in rehabilitationof systolic function of RV in two groups. Thus EDS RV in patients from the 2nd group was 31.4±2.0 sm³, and in patients from the 1st group 25.1±2.2 cm³ (p<0.05), ESS RV in 2nd group became 19.8±2.0 cm³, and in the 1st group 14.4±1.9 cm³ (p<0.05). To the 6th month of disease FIP LV in the 1st group 40.3±3.2%, in the 2nd group 39.4% (p<0.05 in the group). To the 6th month of disease in the 1st group: ACS repeated episodes were in 6 patients (18%), 4 patients with heart failure FC III (12%), death was in 6% (2 patients). In the 2nd group: ACS repeated episodes were in 10 patients (30%) (OR 2.167; 95% CI 0.674-6.967), 7 patients with heart failure fC III (21%), death was in 10% (3 patients) (OR 2.2; 95% CI 0.190-25.517).

Conclusion. The patients with transitory arterial hypotension at the beginning of disease, have the singes of pathological LV remodeling, which complicate the course of disease, but the RV function becomes better.

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