Features of Deformation of Left Ventricular Walls at Thrombosis of Aneurism

Thrombosis of left ventricular (LV) is a frequent concomitant diagnosis in patients with post infarct aneurysm. Thrombus (translated from the Greek-bunch) with aneurysm of LV is a lifelong blood clot in the cavity of the heart's aneurysm. Some of it is attached to the endothelium of the wall of the lungs, which distinguishes the blood clot from the posthumous blood clot. One of the mechanisms for the thrombus formation in the left ventricle is an abnormal way of blood flow. In an aneurysm patient, the stream entering the ventricle during rapid filling does not coincide with the main axis of the lungs. So, several vortex streams are formed that interact with each other and dissipate the kinetic energy of each other. The emergence of turbulent blood flow in the lungs cavity and aneurysms leads to the formation of intracavitary mastoid blood clots. Objective: to investigate the effect of thrombus on the deformation of the walls of LV in patients with post infarct aneurysm. We investigated 63 patients of the «National Institute of Сardio-Vascular Surgery» in the period from 2012 – 2016 with a diagnosis of aneurysm LV. The parameters of the deformation of the stems LV have been determined. In general, patients with aneurysm are characterized by an increase in the volume of LV, a decrease in EF, and as seen from the data, patients with thromboid aneurysms have an even greater LVEDV/BSA, LVESV/BSA, a larger wall thickness and even a smaller fraction of the discharge. There can be seen a significant increase in the indicators of the index of contractile function. The index of residual myocardial volume also indicates the tension of the compensatory process. With the help of Spectral Tracking Echocardiography, longitudinal deformation indices were determined in each segment of the LV and based on these data, the average indices were calculated on the basal, middle, upper appendix and global deflection of the entire LV. It turned out that patients with thrombosis of LV have significant decrease in the parameters of longitudinal deformation at the apex and basal level and global longitudinal deformation. We noted a significant decrease in the rotation rates of the apical and basal divisions in patients with thrombosis of LV and good kinesis of the non-aneurysm zone. As a result, twisting rates were also lower in patients with thrombosis. In patients with thrombosis, there was a statistically significant decrease in the mean longitudinal displacement of basal segments as opposite to patients without LV thromboses. The difference in the above values (deformation, rotation, twisting, displacement) is probably due to several factors: a change in pressure in the LV cavity, an increase in the thickness of the walls of the basal unit, a decrease in the elasticity of the segments to which the fixed thrombus is fixed. Thus, segments of the basal unit which normally deform less than aneurysm, it does not help to move down the lower divisions. Due to the thrombus and dense adjacent segments simply can not deform to the extent of their limited (due to hypertrophy) possibilities. Despite the influence of the thrombus on various links of the mechanism of reduction and reduction of PV, the UI remains statistically unchanged. Probably this is due to the fact that in patients with thrombus, the volume of the left ventricle increases, consequently, the volume of the basal unit increases. However, with a smaller displacement, it still supports the same stroke volume (SV/ BSA).