D.Sh. Gazizova1, M.I. Berseneva2, O.V. Ivleva3, D.A. Malenkov4, L.V. Sazykina5

1–5 A.N. Bakoulev Scientific Center for Cardiovascular Surgery (Moscow, Russia)
1 dgazizova@yandex.ru, 2 miberseneva@bakulev.ru, 3 ovivleva@bakulev.ru,
4 damalenkov@bakulev.ru, 5 sazykinalida@yandex.ru

The relevance of studying the heart load is determined by the need to assess its reserves at different degrees of heart failure for further selection of treatment tactics.

The aim of the work is to evaluate the influence of pressure and cardiac output changes on the left and right ventricular workload in patients with hypertrophic obstructive cardiomyopathy.

The haemodynamic data of 69 patients divided into two subgroups according to the value of cardiac index greater and less than the mean value were considered.

It was found that the change in the left ventricular power of the heart of patients with hypertrophic obstructive cardiomyopathy is determined by the change in both cardiac index and blood pressure. In better-off patients with high cardiac index, the effect of blood pressure is higher and cardiac output is lower. In severe patients with a low cardiac index, the influence of blood pressure is reduced and cardiac index is increased.

The formation of right ventricular power, both in patients with high cardiac index and low, is not affected by changes in cardiac output. Changes in the right ventricular power index are determined by variations in pulmonary artery pressure to a greater extent in well patients and to a lesser extent in severe patients. Since there are 23.1% variations in cardiac index and 60% variations in pulmonary arterial pressure, it is assumed that there is a regulatory mechanism that changes cardiac output opposite to pulmonary artery pressure fluctuations.

Comparison of left and right ventricular power indices with the data given in the literature showed that both for all examined patients with hypertrophic obstructive cardiomyopathy and divided into groups, the average values of left and right ventricular power indices correspond to the range of power fluctuations in healthy people at rest. The range of left ventricular power index variation by 3.5 times, and right ventricular power index variation by 10 times in patients with hypertrophic obstructive cardiomyopathy is determined by multifunctional relationships of cardiovascular system function indices (pressures and cardiac output), which determines the necessity of personalised therapy selection, taking into account the mechanisms of their formation.

The results obtained during the study of the effect of changes in pressure and cardiac index on the power developed by the left and right parts of the heart must be taken into account when choosing therapy in patients with hypertrophic obstructive cardiomyopathy.

Practical significance. The results will be used in the choice of treatment in order to optimize the load on the heart in patients with hypertrophic obstructive cardiomyopathy.

Gazizova D.Sh., Berseneva M.I., Ivleva O.V., Malenkov D.A., Sazykina L.V. Investigation of the load on the heart of patients with hypertrophic cardiomyopathy. Biomedicine Radioengineering. 2024. V. 27. № 5. P. 63–74. DOI: https://doi.org/10.18127/ j15604136-202405-10 (In Russian).

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