Медицинская литература. Новинки

 

 

 

 

 

 

Спекл-трекинг эхокардиография в оценке систоло-диастолической функции левого желудочка при ишемической болезни сердца с учетом особенностей строения миокарда

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В обзоре представлены диагностические возможности спекл-трекинг эхокардиографии (speckle tracking echocardio graphy) для оценки систоло-диастолической функции левого желудочка при ишемической болезни сердца с учетом особенностей строения миокарда. Спиральное строение миокарда и взаимодействие разнонаправленных волокон левого желудочка усложняют задачу оценки регионарной и глобальной сократимости левого желудочка. Спекл-трекинг эхокардиография позволяет измерить деформацию миокарда в продольном, циркулярном и радиальном направлениях. Обсуждается клиническое использование метода при наиболее опасных формах ишемической болезни сердца: остром инфаркте миокарда и нестабильной стенокардии. Спекл-трекинг эхокардиография позволяет выявлять компенсаторное увеличение деформации интактного миокарда, а также ротации левого желудочка при нарушениях локальной сократимости. Измерение глобальных значений деформации, скручивания и раскручивания левого желудочка представляет прогностическую информацию у больных с острым инфарк том миокарда и нестабильной стенокардией. Несмотря на преимущества, существуют препятствия, затрудняющие использование данного метода в клинической практике. Основные из них - качество ультразвукового изображения и отсутствие общепринятых нормативных значений величин деформации.

Ключевые слова:
спекл-трекинг эхокардиография, продольная деформация, циркулярная деформация, радиальная деформация, левый желудочек, ишемическая болезнь сердца, speckle tracking echocardiography, longitudinal strain, circumferential strain, radial strain, left ventricle, coronary heart disease

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Speckle tracking echocardiography in left ventricle systolic-diastolic function assessment in case of coronary heart disease, taking into account structural myocardial characteristics

The review considers the diagnostic value of speckle tracking echocardiography for assessing the left ventricle systolic-diastolic function in ischemic heart disease, taking into account structural myocardial characteristics. Spiral structure of the myocardium and interaction of multidirectional fibers complicate the task of assessing the regional and global contractility of the left ventricle. Use of the speckle tracking echocardiography makes it possible to measure the cardiac strain in the longitudinal, circumferential, and radial directions. Speckle tracking echocardiography clinical use in case of the acute myocardial infarction and unstable angina is discussed. Speckle tracking echocardiography allows detection of the compensatory increase in longitudinal or circumferential strain in cases of left ventricle regional contractility disorders. Assessment of the left ventricular global strain, twist, and untwist provides prognostic information in patients with acute myocardial infarction and unstable angina. Despite the advantages, there are obstacles that make it difficult to use this method in clinical practice. The main ones are the quality of the ultrasound images and the absence of generally accepted normative strain values.

Keywords:
спекл-трекинг эхокардиография, продольная деформация, циркулярная деформация, радиальная деформация, левый желудочек, ишемическая болезнь сердца, speckle tracking echocardiography, longitudinal strain, circumferential strain, radial strain, left ventricle, coronary heart disease