[Gamma-scintigraphy in assessment cardioresynchronizing therapy at chronic heart failure]

The purpose of the work was to study influence of cardioresynchronizing therapy (CRT) on systolic and diastolic myocardial function with the aid of radionuclide methods. 19 patients (9 women) at the age from 21 to 72 years (average age 55.4 +/- 8.3 years) with NYHA class III - IV cardiac insufficiency, dilated cardiomyopathy (n = 14) and ischemic cardiomyopathy (n = 5) were included in the study. Radionuclide angiopulmonography and balanced radionuclide ventriculography were performed by standard method before CRT, in 20 - 30 days and in 12 - 18 months. In 20 - 30 days after CRT significant increase in stroke volume and stroke index, ejection fraction and part of circular fibers contraction was detected, which confirmed improve in systolic heart function. In 12 - 18 months significant increase in maximal filling rate index, filling fraction of 1/3 and 2/3 of diastole was noted, which reflected improve of left ventricle diastolic function. Recovery of myocardial contraction synchronism leaded to rehabilitation of normal pulmonary microcirculation. Radionuclide examination methods as high-informative modes of combine assessment of heart contractile function and pulmonary circulation in CRT dynamics are described. CRT, improving systolic and diastolic myocardial functions, has positive influence on pulmonary hemodynamics in patients with chronic heart failure.