Revaskularizacija miokarda kod bolesnika s kardiomiopatijom

master's thesis

• Title (english): Myocardial revascularization in patients with cardiomyopathy
• Author: Branimir Šušak
• Mentor: Vjekoslav Radeljić (mentor)
• Committee member: Nikola Bulj (predsjednik povjerenstva)
• Committee member: Boško Skorić (član povjerenstva)
• Committee member: Vjekoslav Radeljić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2024-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Ishemijska kardiomiopatija (ICM) predstavlja kardiovaskularnu patologiju sa značajnom stopom morbiditeta i mortaliteta. Karakterizira je široki spektar kliničkih manifestacija i patofizioloških mehanizama, a dijagnoza se temelji na dokazivanju značajnog oštećenja lijeve klijetke zbog prisutnosti uznapredovalih promjena na koronarnim arterijama. Suvremeno liječenje podrazumijeva upotrebu farmakoterapije uz dodatak implantabilnih uređaja prema indikaciji. Korisna uloga revaskularizacije jasna je kod pacijenata s indikacijama poput akutnog koronarnog sindroma. Ipak, kod pacijenata koji su asimptomatski ili pate od stabilne ishemijske bolesti srca utjecaj i smisao revaskularizacije još je predmet istraživanja te, zbog nedostatka velikih randomiziranih studija, nedostaju jasne smjernice postupanja. Cilj ovog preglednog rada je pružiti konstruktivnu procjenu o patofiziologiji ICM-a, ulozi različitih neinvazivnih i invazivnih slikovnih tehnika u dijagnostici ICM-a, diferencijaciji između funkcionalog i nefunkcionalnog miokarda te raspraviti potencijalnu ulogu revaskularizacije i suvremene terapije uređajima u liječenju pacijenata s ICM-om.

Abstract (english)

Ischaemic cardiomyopathy (ICM) represents an important cardiovascular condition associated with substantially increased morbidity and mortality. It is characterised from a broad spectrum of clinical manifestations and pathophysiological substrates and its diagnosis is based on the demonstration of significant left ventricular dysfunction in the context of significant epicardial coronary artery disease. Contemporary management aims at improving prognosis through evidence-based pharmacotherapy and device therapy, where indicated. Whilst the beneficial role of revascularisation remains clear in patients with strong indications such as those with acute coronary syndrome, for those patients that are asymptomatic or suffer from a stable ischaemic heart disease the impact of revascularisation is actively being researched, and the adoption of guidelines is currently hampered by the lack of robust randomised data. The aim of this review is therefore to provide a constructive appraisal on the pathophysiology of ICM, the role of the various non-invasive imaging techniques in the diagnosis of ICM and the differentiation between viable and non-viable myocardium and, finally, discourse the potential role of revascularisation and contemporary device therapy in the management of patients with ICM.

• Keywords: ishemična kardiomiopatija; revaskularizacija; vijabilni miokard; koronarna arterijska bolest
• Keywords (english): ischaemic cardiomyopathy; revascularisation; viable myocardium; coronary artery disease
• Language: croatian
• URN:NBN: urn:nbn:hr:105:829658
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-06-30 14:25:20