PULMONARY HEMODYNAMICS DURING MYOCARDIAL INFARCTION WITH RECURRENT ISCHEMIC EVENTS IN MEN UNDER 60 YEARS OLD
The pulmonary hypertension development and heart failure in myocardial infarction in men with recurrent ischemic events is not well understood. Purpose of the study: to investigate the the pulmonary circulation in men under 60 years old with recurrent ischemic events in myocardial infarction in order to search for possible ways to improve prevention. The study included men 19-60 years old with type I myocardial infarction. The patients were divided into two age-comparable groups: I - study group with recurrent ischemic events (early postinfarction angina and / or recurrent myocardial infarction) - 95 patients; II - control, without them - 470 patients. A comparative assessment of pulmonary circulation parameters in the first 48 hours and the end of the third week of myocardial infarction in these groups was performed. It was found that in the first hours of myocardial infarction, higher values of total pulmonary resistance and mean pressure in the pulmonary artery were noted in the study group. When considering their dynamics at the end of the third week of myocardial infarction, the mean pressure in the pulmonary artery decreased in both groups (I: by 8.7%; p˂0.0001; II: by 15.0%; p˂0.0001). Heart rate - I: 5.96%; p <0.0001 and II: by 7.84%; p = 0.003. Total pulmonary resistance - I: by 32.37%; p = 0.0003 and II: by 29.89%; p <0.0001. At the end of the third week of myocardial infarction, the mean pressure in the pulmonary artery remained elevated in the study group (30.00 ± 10.11 (mm Hg))compared with the control group (27.15 ± 7.93 (mm Hg); p = 0.02). Conclusion. Recurrent ischemic events impair pulmonary circulation at the end of the subacute stage of myocardial infarction, which increases the risk of developing pulmonary hypertension.