Systolic and diastolic dysfunction in patients with metabolic syndrome and history of myocardial infarction before and after coronary artery bypass surgery

Bjective: to analyze characteristics of systolic and diastolic dysfunction in patients with metabolic syndrome and history of myocardial infarction and coronary artery stenosis of various severity and spread before and 2 years after coronary artery bypass surgery. Materials and methods. We examined 42 patients (36 males and 6 females; mean age 52.02 ± 1.72 years) diagnosed with coronary artery disease (CAD), stable angina (functional class III), and history of one or more myocardial infarctions. All patients had essential hypertension and metabolic syndrome. Before surgical revascularization, patients presented with symptoms of NYHA class II chronic heart failure (HF). All patients underwent coronary artery bypass surgery. The severity of coronary lesions before revascularization was assessed using selective coronary angiography by calculating the coronary index. Results. Myocardial revascularization using coronary artery bypass surgery in combination with pharmacotherapy (perindopril or valsartan, bisoprolol, acetylsalicylic acid, clopidogrel and rosuvastatin) during 2 years after surgery in patients with class III angina, history of myocardial infarction, and metabolic syndrome increase exercise tolerance and reduce the functional class of angina. We found a correlation between the regression of systolic and diastolic dysfunction and type of preoperative coronary artery stenosis: less pronounced positive dynamics of systolic and diastolic parameters (ejection fraction, VCF, grade of interventricular septal thickening, left ventricular wall thickening, Е, А, Е/А, IVRT, and DTE) was observed in patients with more severe and spread coronary stenosis. We also found an association between the improvement of overall clinical condition and hemodynamics in patients with metabolic syndrome and history of myocardial infarction.