A-3

Remodeling of the left heart after mitral valve replacement

Toktosunova DB, Kudaiberdiev TZ.
Scientific Research Institute of Heart Surgery and Transplantation of Organs of the Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan.

Objective: For safety of adequate contractility and better remodeling of the left heart after mitral valve replacement procedure, it is obviously to maintain the correct geometric shape of the left heart.

Purpose of the study was  evaluation of immediate results of the mitral valve replacement procedures with full maintenance of subvalvular structures.

Methods:  In the period from March to December 2018, totally 20 patients who underwent mitral valve replacement procedures with full maintenance of subvalvular structures.  Transthoracic echocardiography was performed for all patients on admission and before discharge.

Results:  The average age of patients was 46.9 ± 13.7 years, female sex was in 85% of cases. 80% of patients had heart failure III  and  20 heart failure IV by NYHA classification). Overall 95% of patients simultaneously underwent  tricuspid valve annuloplasty and 45% of patients to left atrial paraannular atrioplasty.

 

Ten patients who underwent atrioplasty had decline of left atrium dimension  from 54 ± 7.9 mm to 42.6 ± 5.9 mm and volume from 164.2 ± 76.2 ml to 70.7 ± 31.4 ml. Also, all patients had decline of left ventricle end-diastolic volume from 82.2±42.1mm to 67.3±10.2 mm and end-systolic volume from 33.0±14.3mm to 25.8±7.3mm, before and after procedures respectively.

Conclusion: Mitral valve replacement procedure with preservation of the entire subvalvular apparatus allows maintaining the correct geometric shape of the left ventricle, which helps to reduce its volume and size. Performing of paraannular аtrioplasty of the left atrium significantly reduces the size and volume of the left atrium. Full maintenance of subvalvular structures in the mitral valve replacement procedures with atrioplasty of the left atrium allows improving the function of the left ventricle and intracardiac hemodynamics in the nearest postoperative period.

A-4

The preliminary results of athletic heart study: left heart enlargement in male adolescent athletes with early repolarization pattern

Damirbek Abibillaev¹, Taalaibek Kudaiberdiev^1,2
1Scientific-Research Institute of Heart Surgery and Organ Transplantation
²Center for Postgraduate Education and Research

Objective: Early repolarization pattern (ERS) is frequent finding of athletic heart syndrome. In this observational study we analyzed the association of ERS with left cardiomegaly in male adolescent athletes.

Methods: a total of 65 male adolescent athletes with regular training background of minimal four years of Greco-Roman and freestyle wrestling categories of the Republican School of Olympic Reserve were enrolled in standard electrocardiographic and echocardiographic examinations for evaluation of athlete heart syndrome. Adolescents were divided into two groups on the basis of early repolarization pattern: ERS-group (n=34) and non-ERS (n=31). Chi-square analysis was conducted to association between electrocardiographic ERP with echocardiographic continuous variables.

Results: Baseline clinical, electrocardiographic and echocardiographic data were collected. Continuous variables was presented as mean ± standard deviation (SD) for normally-distributed data or median and interquartile range (IQR) for abnormally-distributed data. Athletes of both group did not show significant difference by BMI and heart rate (p=0,65 and p=0,74, respectively). However, statistical difference was found in mean left ventricular sizes and left atrial sizes: EDD: 56.34mm vs 46.32mm, p=0.047; ESD: 37.65mm vs 32.24mm, p=0.05 and LA: 37.76mm vs 31.49mm, p=0.043. Other echocardiographic measurements including LV systolic function parameters did not show significant difference.

Conclusion: left heart enlargement is associated to electrocardiographic early repolarization pattern in adolescent athletes.

Key words: sports cardiology, early repolarization pattern, cardiomegaly, athlete, athletic heart syndrome, adolescent, echocardiographic chamber assessment.