Сhronic heart failure impact on stroke index and ejection fraction during polytrauma
Authors: Lutska Svitlana 
Published: April 2024

Study of the effect of heart failure on the course of hypovolemia duringpolytrauma with the absence of traumatic myocardial injury. The study involved 95 patients, whowere divided into 3 groups. The first Control group (C), 29 patients had no heart failure. Thesecond group was Standard (S), 33 patients suffered from chronic heart failure and receivedstandard therapy according to the protocol. The third group (E) of 33 patients with chronicheart failure who, in addition to standard therapy according to protocol, receivedEthylmethihydroxypyridine succinate. Patients of groups S and E had equal inclusion criteria,namely the main disease leading to chronic heart failure was arterial hypertension, which hadexisted for more than 5 years. Three groups of patients had no traumatic myocardial injury. Thestroke index (SI) during admission of group C is 24.7±4.8 ml/m 2 , on the 3rd day 32.8±5.0 ml/m 2 ,(p &lt;0.001), and on the 7th day - up to 39.1±6.0 ml/m 2 , (p &lt;0.001). SI of group S duringadmission was 22,9±3,7 ml/m 2 , on the 3rd day 26,9±4,7 ml/m 2 (p &lt;0,001), and on the 7th day —

34,6±5,5 ml/m 2 (p &lt;0,001). SI of group E patients during admission was 23.4±2.7 ml/m 2 , on the3rd day 26.1±1.5 ml/m 2 (p &lt; 0.01), and on the 7th - up to 36.8±2.2 ml/m 2 (p &lt; 0.01). Cardiacindex (CI) of group C within admission was 2,26±0,35 l/min∙m 2 , on the 3rd day - 2.73±0.37l/min∙m 2 (p &lt;0,001), and by the end of the study - up to 3.08±0.40 l/min∙m 2 (p &lt;0,001). CI ofgroup S during admission amounted to 1,99±0,39 l/min∙m 2 , on the 3rd day - 2,22±0,31 l/min∙m 2(p &lt;0,02), on 7th — up to 2.67±0.33 l/min∙m 2 (p &lt;0.001). CI of group E - 2,0±0,38 l/min∙m 2 .Until the 3rd day — 2,06±0,30 l/min∙m 2 (p&gt; 0.4), at the 7th reached 2.97±0.32 l/min∙m 2 (p&lt;0,001). Ejection fraction (EF) of group C within admission amounted to 53.7±3.4%. In thefuture, EF has significantly increased, reaching 59.6±5.2% (p &lt;0.001) and 63.3±6.4% by the 7thday (p &lt;0.01). EF of group S during admission was 47,9±4.7%, on the 3rd day it increased to52.2±5.2% (p &lt;0.001), and on the 7th - to 56.8±6.9% (p &lt;0.001). EF of patients group E withinthe admission was - 47.5±6.9%. On the 3rd day, the EF authentically increased to 52.3±5.3%(p&lt;0.003), and on the 7th day - to 61.5±6.4% (p &lt;0.001). The inclusion ofEthylmethylhydroxypyridine succinate (EMGPS) in the intensive care scheme of E grouppatients with chronic heart failure during polytrauma without acute myocardial injury graduallyimproves myocardial contractility activity (MCA). On the 3rd day after patient’s admission, asignificant impact of EMGPS on the study of mechanics and energy indicators was not observed.But from the 7th day there was an increase in SI on 6.4% (36.8±1.2 contrary 34.6±5.5 ml/m 2 , p= 0.03), an increase in EF on 8.3% (61.5± 6.4 contrary 56.8±6.9%, p = 0.005), CI increased on11.2% (2.94±0.32 contrary 2.67±0.33 l/min∙m 2 , p &lt; 0.001). Thus, the addition of EMGPS to theintensive care scheme to patients with chronic heart failure during polytrauma without acutemyocardium injury optimizes blood circulation and its energy efficiency.Ethylmethylhydroxypyridine succinate optimizes the energy efficiency of blood circulation inpatients with chronic heart failure during polytrauma without acute myocardial injury.