А.I. ABDRAHMANOVA^{1, 2}

 ¹Kazan Federal University, Kazan

²Interregional Clinical Diagnostic Center, Kazan

 Contact details:

Abdrahmanova A.I. — PhD (medicine), Associate Professor of the Department of Internal Diseases

Address: 74 Karl Marx St., Kazan, Russian Federation, 420012, tel.: +7-917-922-66-29, еmail: alsuchaa@mail.ru

 The purpose — to analyze the results of stress-EchoCG in patients with and without silent myocardial ischemia (SMI).

Material and methods. Results of stress-EchoCG of 202 patients during exercise test (ET) on treadmill according to Bruce protocol were analyzed.

Results. Patients with SMI were 2.5 times more likely to achieve submaximal heart rate (p = 0.015) compared with the control group (CG). With the same exercise load, the maximum heart rate was higher in SMI group (p = 0.04). Maximum depression of ST segment was greater in SMI than in CG (p = 0.04). Dynamic of ST segment during ET was found in 75.6% subjects in SMI group and in 36.6% subjects in CG (p = 0.0001). Decrease in myocardial contractility during ET was 80.5% in SMI and 34.1% in CG (p = 0.0001). Combination of ST segment depression and contractility decrease was 56% in SMI and 9.2% in CG (p = 0.0001). In SMI, contractility decrease was found in 84.2% of segments.

Conclusions. Decrease in contractility is higher in SMI than in CG. Positive ET with ST segment depression is more common in SMI. Depression of ST segment on positive ET was deeper in SMI than in CG. Negative test happens more often at SMI. Duration of ET in SMI was shorter due to rapid achievement of submaximal heart rate or ST segment depression. In SMI, ischemic manifestations occurred earlier and were more severe than in CG. Combination of segmental contractility disorders and ST segment depression in ET is a feature of myocardium in SMI.

Key words: silent myocardial ischemia, Holter monitoring, electrocardiography.

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