Authors
Midlenko O.V.1, 2, Chavga A.I.1, 2, Midlenko V.I.1, 2, Ruzov V.I.1, Belonogov N.I.1
1 Ulyanovsk State University, Ulyanovsk
2 Ulyanovsk Regional Clinical Center for Specialized Types of Medical Care named after E.M. Chuchkalova», Ulyanovsk
Abstract
Rationale: Echocardiographic changes are observed in more than 50% of patients with acute pancreatitis. Studying the phenomenon of cardiodepression in patients with acute pancreatitis will make it possible to predict the development of moderate and severe pancreatitis.
Purpose of the study: to identify the characteristic echocardiographic signs of cardiac dysfunction and their relationship with the severity of acute pancreatitis.
Material and methods of research: 81 people participated in the research. Of these, there were 21 healthy volunteers and 60 patients with acute pancreatitis. There were 36 men and 24 women.
The results of their own research: having studied the end diastolic volume of the left ventricle (EDV), the authors came to the conclusion that a very large spread of values even in healthy individuals does not allow using this indicator to assess the state of the myocardium. And even more so forecasting. It became obvious that for greater objectification it is necessary to take into account, first of all, the size of the heart. To simplify the calculations, as an indicator indirectly characterizing the size of the heart, the authors decided to use the thickness of the interventricular septum in diastole (IVD). Thus, having EDV and IVS, the authors proposed to use the diastolic coefficient (DK) = EDV / IVS. After analyzing the value of this indicator, the authors found that most often in moderate and severe pancreatitis, established for a completed case, DC was below 9. The diastolic coefficient of DC proposed by the authors, calculated on the first day of treatment, also showed a clear relationship with the severity of pancreatitis, established by the completed case.
Conclusions: if, in the absence of hypovolemia and signs of heart failure in patients with acute pancreatitis on the first day of adequate treatment, the value of the diastolic ratio is less than 9, the relative risk of developing moderate and severe pancreatitis is 5.991 at S - 0.359. The diastolic ratio proposed by the authors is a prognostically significant indicator for the development of moderate and severe pancreatitis. The sensitivity of the proposed prediction method is 0.788, the specificity is 0.896.
Keywords: acute pancreatitis, diastolic coefficient, therapeutic tactics, prognosis, interventricular septum.
References
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