systhiperСистемные гипертензииSystemic Hypertension2075-082X2542-2189LLC «ИнтерМедсервис»10.26442/2075082X.2019.2.190180systhiper-580Research ArticleСТАТЬИARTICLESДинамика ЭКГ-показателей у больных хронической тромбоэмболической легочной гипертензией после транслюминальной баллонной ангиопластики легочных артерийDynamics of ECG indicators in patients with chronic thromboembolic pulmonary hypertension after transluminal pulmonary balloon angioplastyКарабашеваМ. Б.KarabashevaM. B.madi.karabasheva@yandex.ruДаниловН. М.DanilovN. M.noemail@neicon.ruСагайдакО. В.SagaidakO. V.noemail@neicon.ruМатчинЮ. Г.MatchinI. G.noemail@neicon.ruЧазоваИ. Е.ChazovaI. E.c34h@yandex.ruФГБУ «НМИЦ кардиологии»РоссияA.L. Myasnikov Institute of Clinical Cardiology, National Medical Research Center for CardiologyRussian Federation2019231220221622831Copyright © Карабашева М.Б., Данилов Н.М., Сагайдак О.В., Матчин Ю.Г., Чазова И.Е., 20222022Карабашева М.Б., Данилов Н.М., Сагайдак О.В., Матчин Ю.Г., Чазова И.Е.Karabasheva M.B., Danilov N.M., Sagaidak O.V., Matchin I.G., Chazova I.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.syst-hypertension.ru/jour/article/view/580

Актуальность. Хроническая тромбоэмболическая легочная гипертензия (ХТЭЛГ) - прекапиллярная форма легочной гипертензии, которая развивается вследствие обструкции легочных артерий тромботическими массами. Транслюминальная баллонная ангиопластика (ТЛА) - альтернативный метод лечения неоперабельной ХТЭЛГ который продемонстрировал хорошие гемодинамический и клинический эффекты. В данной работе рассматривается динамика ЭКГ-показателей после ТЛА в отдаленном периоде. Материалы и методы. В исследование включены 15 пациентов с неоперабельной ХТЭЛГ, которым оценивались показатели гемодинамики, функционального статуса и ЭКГ-показатели до ТЛА, непосредственно после и через 1 год. Результаты. Отмечено значимое снижение всех важных гемодинамических показателей. Предикторами улучшения среднего давления в легочной артерии (ДЛА) были амплитуды зубцов S в отведении V1 и R в отведении V5. Ширина QRS-комплекса и амплитуда зубца Р в отведении II были определены как достоверные факторы, влияющие на степень улучшения среднего ДЛА. Нормализация (<10 мм) суммы амплитуд зубцов R в отведении V1 и S в отведении V5 определены как предикторы более высокого функционального статуса пациента в отдаленном после ТЛА периоде. Выводы. ТЛА - эффективный и в отдаленном периоде метод лечения больных с неоперабельной ХТЭЛГ. ЭКГ-критерии гипертрофии правого желудочка могут использоваться в качестве показателей эффективности ТЛА.

Relevance. Chronic thromboembolic pulmonary hypertension is a precapillary form of pulmonary hypertension that develops as a result of the obstruction of the pulmonary arteries by thrombotic masses. Balloon pulmonary angioplasty is an alternative method of treatment of inoperable CTEPH that has demonstrated hemodynamic and clinical effects. In this study we evaluated the relationship between the improvement in hemodynamic and functional status and ECG in patients with CTEPH who underwent BPA treatment. Materials and methods. In 15 patients with CTEPH, we examined the hemodynamic data before and 1 year after BPA. In addition, the sequential ECG findings for right ventricular hypertrophy (RVH) were assessed. Results. There was a significant decrease in all important hemodynamic parameters. Predictors of the improvement in mean PAP were the amplitudes of the S waves in lead V1 and R in lead V5. The width of the QRS complex and the amplitude of the P wave in lead II were identified as significant factors influencing the degree of improvement in the mean PAP. Normalization (<10 mm) of the sum of the amplitudes of the R waves in lead V1 and S in lead V5 are defined as predictors of a higher functional status of the patient in the period after TLA. Conclusion. BPA therapy is reduced pulmonary arterial pressure and improved patients functional status that associated with an improvement in the ECG findings related to RVH which can be used as indicators of the effectiveness of procedure.

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The authors declare that there are no conflicts of interest present.