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Диастолическая трансторакальная стресс-эхокардиография с дозированной физической нагрузкой в диагностике сердечной недостаточности с сохраненной фракцией выброса: показания, методология, интерпретация результатов

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Диагностика сердечной недостаточности с сохраненной фракцией выброса сопряжена с определенными трудностями, поскольку многие пациенты с сердечной недостаточностью с сохраненной фракцией выброса имеют незначительную диастолическую дисфункцию левого желудочка и нормальное давление его наполнения в покое. Для улучшения диагностики сердечной недостаточности с сохраненной фракцией выброса используется диастолическая трансторакальная стресс-эхокардио графия с дозированной физической нагрузкой (диастолический стресс-тест), позволяющая выявить признаки повышения давления наполнения во время нагрузки. В настоящем согласованном мнении экспертов разъясняется необходимость проведения диастолического стресстеста для диагностики сердечной недостаточности с сохраненной фракцией выбро са с клинической и патофизиологической точек зрения, определяются показания к тесту с описанием его методологических аспектов, рассматриваются вопросы применения теста у особых категорий пациентов.

Ключевые слова:
стресс-эхокардиография, левый желудочек, давление наполнения, диастолическая дисфункция, сердечная недостаточность с сохраненной фракцией выброса, диагностика, диастолический стресс-тест, stress echoc

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Diastolic transthoracic stress echocardiography with incremental workload in the evaluation of heart failure with preserved ejection fraction: indications, methodology, interpretation

Diagnosis of heart failure with preserved ejection fraction is challenging due to many patients have only mild left ventricular diastolic dysfunction and normal left ventricular filling pressure at rest. The diastolic transthoracic stress echocardiography with incremental workload (diastolic stress test) refers to the assessment of the diastolic function during exercise, thus enhancing the verification of heart failure with preserved ejection fraction. The present expert consensus statement provides the clinical and pathophysiological rationale for diastolic stress test in the evaluation for heart failure with preserved ejection fraction, the methodology of diastolic stress test, the principles of data interpretation, and applicability for the specific groups of patients.

Keywords:
стресс-эхокардиография, левый желудочек, давление наполнения, диастолическая дисфункция, сердечная недостаточность с сохраненной фракцией выброса, диагностика, диастолический стресс-тест, stress echoc