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Современные методы эхокардиографической оценки функционального состояния левого предсердия при фибрилляции предсердий

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Фибрилляция предсердий (ФП) является наиболее распространенной сердечной аритмией, сопровождающейся значительной заболеваемостью и смертностью среди всего населения. При ФП именно левое предсердие (ЛП) рассматривается как критический показатель развития неблагоприятных сердечно-сосудистых событий. Дилатация ЛП с последующим электрофизиологическим ремоделированием частое наблюдение у пациентов с ФП.Таким образом, особый интерес представляет эхокардиография (ЭхоКГ), в частности использование двухмерной и трехмерной “спекл-трекинг”-ЭхоКГ (Speckle tracking echocardiography) для изучения морфофункционального состояния ЛП у постели больного.В настоящее время в отечественной литературе представлено несколько крупных лекционных обзоров по эхокардиографической оценке функции ЛП, но не изучена роль отдельных методов лучевой визуализации и их корреляции друг с другом, существует только пара зарубежных метаанализов по оценке и анализу функционального состояния ЛП у пациентов с ФП. Данная проблема актуальна, так как установление предикторов ФП на ранней стадии, в частности при ее скрытом течении, дает возможность предотвратить развитие ряда осложнений, ассоциированных с аритмией, – от ишемических инсультов до внезапной сердечной смерти.Цель данного литературного обзора: представить данные последних исследований по оценке структуры и функции ЛП с использованием “спекл-трекинг” ЭхоКГ для выявления пациентов с бессимптомным течением ФП или высоким риском ее рецидива после процедур абляции.

Ключевые слова:
фибрилляция предсердий, левое предсердие, спекл-трекинг-эхокардиография, atrial fibrillation, left atrium, speckle tracking echocardiography

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Modern methods of echocardiographic assessment of the functional status of the left atrium in atrial fibrillation

Atrial fibrillation (AF) is the most common cardiac arrhythmia, accompanied by significant morbidity and mortality among the entire population. In AF, it is the left atrium (LA) that is considered as a critical indicator of the development of adverse cardiovascular events. LA dilation followed by electrophysiological remodeling is a frequent observation in patients with AF.Thus, echocardiography (EchoCG) is of particular interest, in particular, the use of two-dimensional and threedimensional Speckle tracking echocardiography (STE) to study the morphofunctional state of LA at the patient's bedside.Currently, several major lecture reviews on echocardiographic assessment of LA function are presented in the domestic literature, but individual methods of radiation imaging and their correlation with each other have not been studied, there are only a couple of foreign meta-analyses on the assessment and analysis of the functional state of LA in patients with AF. This problem is relevant, since the establishment of predictors of AF at an early stage, in particular with its latent course, makes it possible to prevent the development of a number of complications associated with arrhythmia from ischemic strokes to sudden cardiac death.The purpose of this literature review is to present the data of recent studies on the assessment of the structure and function of LA using STE to identify patients with asymptomatic AF or a high risk of its recurrence after ablation procedures.

Keywords:
фибрилляция предсердий, левое предсердие, спекл-трекинг-эхокардиография, atrial fibrillation, left atrium, speckle tracking echocardiography