Scintigraphic investigation methods in pulmonary hypertension diagnostics and lesser pulmonary circulation reserve potential evaluation among patients with mitral valve failure

Pulmonary hypertension and bloodstream affection are considered to be major factors that determine indication for operation and limit its successful fulfillment among patients with mitral valve failure. This paper aims to develop new systematic approach to radionuclide diagnostics of pulmonary hypertension and to evaluate reserve potential of lesser pulmonary (LP) hemodynamics among patients with mitral valve failure. 35 patients aged 28 to 55 (the average age rate is 45,0±2,4 years) having II-III stage of mitral stenosis and various pulmonary hypertension intensity have been examined. The evaluation of lesser pulmonary circulation (LPC) potential has been carried out with the application of acute aminophyllin test under direct manometry of the right ventricle of heart and pulmonary artery. Obtained data of pressure direct measurement have been compared with the results of radionuclide angiocardiography (RACG). Comparing the results of direct manometry in the right ventricle of heart (RVH) cavities and pulmonary artery (PA) with parameters calculated on the basis of conducted radionuclide investigations, the notions of scintigraphic index "Crvh/Cpa" (correlation of the evacuation constants from the radiopharmaceutical right ventricle of heart and pulmonary artery, and mean pulmonary arterial pressure.) During the acute pharmacological aminophyllin test direct connection of pressure in pulmonary artery and right ventricle of heart measured by the direct method with the correlation of CRVH/CPA has been detected. Carried out analysis of the obtained data showed that among people with "positive" reaction for aminophyllin early postoperative period passed without any complications with the parameters recovery of a LP hemodynamics. However, among patient shaving no LPC reaction for aminophyllin the residual pulmonary hypertension and right ventricular overload after surgical correction was still present. Suggested method of indirect pressure definition in pulmonary artery using radionuclide angiocardiography allows it objectively and accurately evaluate pulmonary hypertension level among patients with mitral valve failure. The application of acute pharmacological aminophyllin test allows to evaluate the reserve potential of lesser pulmonary circulation a- mong such patients.