Methods: 112 patients were participated in the study. Inclusion criteria: myocardial infarction in previously; angina II-III functional class (CCS); multivessel coronary disease (SYNTAXscore I <32); the presence of segments with abnormality left ventricular local contractility; chronic heart failure I-III functional class (NYHA); left ventricular ejection fraction (LVEF) is less than 45%. All patients underwent stenting of the coronary arteries in the zone of viable myocardium. Only drug-eluting stents were implanted in coronary arteries. Long-term results were followed up 18 months after PCI in all patients. All patients underwent stress-echocardiography and CMR for visualization of myocardium after PCI.
Results: on average, initially accounted for 2.12 ± 0.74 segments with abnormality kinetic per patient according CMR, whereas, according to stress echocardiography, the average number of segments was 1.96±0.42. The average difference was 0.16 segment [0.11-0.18; 95% CI, p=0.003]. In the postoperative period, after 18 months, there was a significant decrease a segments with abnormality kinetics in the zone of hibernated myocardium, from 2.12 to 1.08, according to CMR (the average difference was 1.04 segment) [0.98-1.1; 95% CI, p <0.01], and from 1.96 to 0.98 according to stress-echocardiography (the average difference was 0.98 segments) [0.94–0.99; 95% CI, p = 0.023]. There is a significant discrepancy between the number of identified segments with abnormality kinetics using CMR and stress- echocardiography. There was a significant decrease in the transmurality index from 0.42 to 0.31 (according to CMR). The difference was 0.11 [0.09-0.14; 95% CI, p <0.05]. At the same time, recovery of myocardial function was clearly manifested in patients with a trasmurality index of 0.3–0.5, whereas with a transmurality index of more than 0.5, reliable recovery of myocardial function was not observed.
Conclusion: CMR allows a more objective analysis of the results of PCI in patients with dysfunctional myocardium, as compared with the stress-echocardiography method.