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Aim. To study the effects of transluminal balloon angioplasty (TLBAP) and stenting on right and left ventricular (RV, LV) hemodynamics, as well as on long-term clinical prognosis, in patients with ischemic chronic heart failure (CHF). Material and methods. In 20 patients with ischemic CHF, Functional Class (FC) II–III (NYHA), radionuclide 4D tomoventriculography (4D-RTVG) was performed at baseline and 6 and 12 months after TLBAP, in order to assess cardiac hemodynamics. Based on ejection fraction (EF) values, all participants were divided into two groups. Group I (n=10; mean age 57,2 (2,7) years) included men with EF <45%, FC II–III CHF, and mean CHF duration of 3,1 (0,6) years. Group II (n=10; mean age 62,6 (2,7) years) included 5 men and 5 women with EF >45%, FC II CHF, and CHF duration of 2 (0,4) years. Results. Twelve months after TLBAP, Group I demonstrated a significant increase in stroke volume (SV), LV EF, and RV EF, as well as an improvement in LV maximum ejection velocity (MEV), maximum filling velocity (MFV), and maximum filling time (MFT), as well as in LV and RV one-third filling fraction (1/3 FF) (p<0,05). A decrease in LV enddiastolic volume (EDV), LV end-systolic volume (ESV), and RV ESV, some increase in RV EDV, and an improvement in RF MEV, MFV, and MFT were non-significant (p>0,05). In Group II, an increase in LV SV and LV EF, as well as an improvement in RV 1/3FF and MFT, was statistically significant (p<0,05). At the same time, an increase in RF SV, EF, EDV, and ESV, as well as an improvement in LV and RV MEV and MFV, LV 1/3FF and LV MFT, without any substantial changes in LV EDV and ESV, lacked statistical significance (p>0,05). Cardiac hemodynamic changes were associated with improved quality of life (QoL) and reduced CHF FC and angina FC. Conclusion. TLBAP and stenting facilitated an increase in EF and SV, an improvement in LF and RF systolic and diastolic function, an improvement in QoL and exercise capacity, and a reduction in CHF FC and angina FC.

Purpose: Assessment of the impact of absorption correction (AC) on quantitative parameters of myocardial perfusion and determination of the extent of stress-induced myocardial microcirculation disorders on SPECT / CT in patients with chest pain and unchanged coronary arteries. Material and methods: the study included 35 patients, each of whom was carried a selective coronary angiography and rest/stress SPECT/CT of the myocardium with 99mTc -MIBI with- and without CA. Results: In all patients with stress-induced myocardial ischemia was detected both without and with AC images. However, quantitative parameters of myocardial perfusion were lower after the AC: SSS 6.9 ± 1.2 vs. 7.7 ± 1.1; SDS 4.0 ± 0.8 vs. 4.9 ± 0.6; Stress ext. Total 11.2 ± 1.8 vs. 13.0 ± 1.9; Stress TPD total 9.3 ± 1.2 vs.10.9 ± 1.2; TPDi 4.1 ± 1.0 vs.5.9 ± 0.9 (for all p < 0.05). For SRS, Rest ext. Total, and Rest TPD total difference was not significant. The number of hypoperfused segments, according to the segmental analysis, was less after AC and was 126 vs. 153 at rest, 242 vs. 177 under stress. In women, significant difference was obtained for all parameters, for men – only for the SSS, SDS, Stress ext. Total, Stress TPD total. In patients with BMI ≥25 significant difference for all parameters was obtained. However, patients with the normal BMI (18,5–24,9;WHO, 2004) significant difference was obtained only for Stress ext. Total, Stress TPD total. Conclusion The use of SPECT/CT with AC allow to detect microcirculatory violations of perfusion and myocardial reserve perfusion in patients with pain in the chest with the unchanged CA, as evidenced by indicators of the average values of quantitative parameters of perfusion scintigram. The most significant impact on the quantitative perfusion parameters was observed in women with well-developed breasts and obese patients. The findings give reason to assume the use of AC to avoid revaluation incidence and severity of stress-induced myocardial perfusion disturbances.

The diagnosis and treatment of patients with angiographically normal or near normal coronary arteries remains a clinically relevant problem. The aim of this study was to assess diastolic function in patients with chest pain and normal/near normal coronary arteries (NECA) using ECG-gated SPECT/CT. The study recruited 49 patients presenting with chest pain, a positive cardiac stress test and normal coronary arteries, as demonstrated by coronary angiography. All patients were ordered a myocardial SPECT/CT scan, which was performed according to a two-day protocol. After the scan, the patients were divided into 3 groups. Group 1 consisted of 17 patients with microvascular angina. Group 2 was composed of 22 patients with borderline-high blood pressure or stage I hypertensive heart disease associated with secondary microvascular dysfunction. Ten seemingly healthy individuals constituted the control group. According to coronary angiography, the controls had no cardiovascular pathologies accompanied by coronary artery disorders or impaired myocardial perfusion (SPECT). The majority of patients from groups 1 and 2 were found to have impaired diastolic function. The impairments were more pronounced in group 2 tended to exacerbate with stress. The most sensitive parameter of diastolic function, MFR/3, was outside the reference range in almost all patients in groups 1 and 2. MFR/3 characterizes the mean filling rate of the left ventricle in the first third of diastole. The control group showed no symptoms of diastolic dysfunction. Thus, the patients with chest pain, a positive stress test and NECA had signs of left ventricular diastolic dysfunction exacerbated with stress. Such patients are at risk for heart failure with preserved ejection fraction.