Regularities of changes in the quality of life in men under60 years with pulmonary hypertension in myocardial infarction

Abstract

Background. Pulmonary hypertension (PH) complicates the course and worsens the prognosis of myocardial infarction (MI). It is closely associated with the formation of heart failure (HF). Single techniques are known for early non invasive diagnosis of quality of life associated with heart failure (HFQL) in the initial periods of MI. Purposes and tasks. To assess changes in HFQL in men younger than 60 years of age with PH, which occurred in the subacute period of MI, to improve prevention. Materials and methods. The study included men aged 19-60 years old with MI and various dynamics of mean pulmonary artery pressure (MPAP) (A. Kitabatake) in the first 48 hours (1) and the completion of the third week (2). Patients were divided into four groups: the studied group (I) included 84 patients (mean age 50.4 ± 7.1 years) with PH (MPAP2 25 and more mm Hg) and normal level of MPAP1. Group II included patients with a normal MPAP in both phases of the study (88 patients, 52.1±6.6 years); group III - with elevated MPAP at both points of the study (184 patients, 51.2±5.5 years) and IV - with increased MPAP1 and normal MPAP2 (94 patients, 49.5±6.8 years). A comparative assessment of HFQL (V. Ironosov) was performed in the selected groups and points. The dynamics and relationships of HFQL with clinical signs, metabolic parameters, hemodynamics, and MI prediction indices were studied. The results. Significant improvement (73-78%) of HFQL was revealed over the observation period in all groups of patients. Differences in HFQL depending on the presence of PH were not detected. The most negative levels of HFQL were observed in groups with PH in the second point. Statistically significant correlations of weak and medium strength between the HFQL of the study group and the age of the patients, hemodynamic and metabolic parameters were obtained. Conclusions. HFQL does not significantly differ in patients with PH arising in the subacute period of myocardial infarction, compared with control groups with different dynamics of SDL in the initial periods of myocardial infarction. The most pronounced negative effect on MPAP in the study group is exerted by the patient’s age and hemodynamic parameters.