vtioВестник трансплантологии и искусственных органовRussian Journal of Transplantology and Artificial Organs1995-1191Academician V.I.Shumakov National Medical Research Center of Transplantology and Artificial Organs", Ministry of Health of the Russian Federation10.15825/1995-1191-2014-2-52-59vtio-202Research ArticleКлиническая трансплантологияClinical TransplantologyИЗМЕНЕНИЯ ПЕРФУЗИИ И ФУНКЦИИ МИОКАРДА ПОСЛЕ ТРАНСПЛАНТАЦИИ ПЕЧЕНИ У ВЗРОСЛЫХ. РЕЗУЛЬТАТЫ ПЕРФУЗИОННОЙ ТОМОСЦИНТИГРАФИИ, СИНХРОНИЗИРОВАННОЙ С ЭКГMODIFICATION OF MYOCARDIUM FUNCTION AND PERFUSION AFTER LIVER TRANSPLANTATION. RESULTS OF MYOCARDIAL SCINTIGRAPHYМалиновскаяЮ.О.MalinovskayaY.O.yumalinovskaya@gmail.comОстроумовЕ.Н.OstroumovE.N.1@ru.ruКотинаЕ.Д.KotinaE.D.1@ru.ruМойсюкЯ.Г.MoysyukY.G.1@ru.ruФГБУ «Федеральный научный центр трансплантологии и искусственных органов им. академика В.И. Шумакова» Минздрава РФ, МоскваРоссияV.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow, Russian FederationRussian FederationCанкт-Петербургский государственный университет, Санкт-ПетербургРоссияSt. Petersburg State University, St. Petersburg, Russian FederationRussian FederationФГБУ «Федеральный научный центр трансплантологии и искусственных органов им. академика В.И. Шумакова» Минздрава РФ, Москва Кафедра трансплантологии и искусственных органов Первого Московского государственного медицинского университета им. И.М. Сеченова, МоскваРоссияV.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, Moscow, Russian Federation Department of Transplantology and Artificial Organs I.M. Sechenov First Moscow State Medical University, Moscow, Russian FederationRussian Federation201424052014162ВЕСТНИК ТРАНСПЛАНТОЛОГИИ И ИСКУССТВЕННЫХ ОРГАНОВ том XVI No 2–20145259Copyright © Малиновская Ю., Остроумов Е., Котина Е., Мойсюк Я., 20142014Малиновская Ю., Остроумов Е., Котина Е., Мойсюк Я.Malinovskaya Y., Ostroumov E., Kotina E., Moysyuk Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.transpl.ru/vtio/article/view/202Цель

Цель. Проведение оценки изменений функции и перфузии миокарда у взрослых пациентов с циррозом печени и после ортотопической трансплантации печени (ОТП) с помощью однофотонной эмиссионной компьютерной томографии миокарда, синхронизированной с ЭКГ (ОФЭКТ с ЭКГ).

Материалы и методы

Материалы и методы. В исследование были включены 12 пациентов.

Результаты

Результаты. После трансплантации печени происходит регрессия гемодинамических изменений, характерных для больных циррозом печени: увеличение конечного систолического объема (КСО) с 23 до 33 мл (p = 0,026), снижение в пределах нормы фракции выброса левого желудочка (ФВ ЛЖ) с 76 до 60% (p = 0,08), снижение расчетного минутного выброса с 4941 до 3066 мл/мин (p = 0,009), снижение минутной скорости изгнания (МСИ) с 314 до 218 мл/сек (p = 0,003), снижение минутной скорости наполнения левого желудочка с 248 до 182 мл/сек (p = 0,037). Также уменьшился коэффициент эксцентричности с 0,81 до 0,77 (p = 0,028), что говорит об увеличении шарообразности полости ЛЖ. У большинства пациентов нарушений перфузии миокарда выявлено не было, но у двух пациентов наблюдалось локальное нарушение перфузии на верхушке ЛЖ, изменившееся в динамике после ОТП.

Заключение

Заключение. После трансплантации печени происходит регрессия гипердинамического синдрома, снижение систолической функции, регрессия диастолической дисфункции. Требуются дополнительные исследования для определения применимости данного метода при обследовании кандидатов на трансплантацию печени.

Aim evaluated function and perfusion of myocardium in 12 cirrhotic patients before and after liver transplantation (LT).

Materials and methods

Materials and methods. ECG-gated single photon emission computed tomography (SPECT) was used.

Results

Results. It was found that hyperdynamics diminished liver transplantation: left ventricle (LV) end-systolic volume (ESV) rose from 23 to 33 ml (p = 0,026), LV ejection fraction decreased staying normal from 76 до 60% (p = 0,08), calculated cardiac output declined from 4941 to 3066 ml/min (p = 0,009), peak ejection rate (PER) from 314 to 218 ml/sec, (p = 0,003), peak fi lling rate decreased from 248 to 182 ml/sec (p = 0,037), eccentricity coeffi cient also decreased from 0,81 to 0,77 (p = 0,028). Local alteration of perfusion was found only in 2 cases.

Conclusion

Conclusion. Hyperdynamic systolic dysfunction and diastolic dysfunction improve after liver transplantation. Further studies are required to estimate the applicability of SPECT in liver transplantation candidates’ evaluation.

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