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Эхокардиография при ишемической болезни сердца на современном этапе

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Эхокардиография - активно развивающаяся ультразвуковая диагностическая методика, играющая ключевую роль при обследовании пациентов с ишемической болезнью сердца. За последние годы произошли важные изменения в протоколах выполнения и методах анализа эхокардиографии покоя и нагрузки, применяемых у пациентов с ишемической болезнью сердца. Наряду со стандартным визуальным анализом локальной сократимости широко используется режим тканевого следа для количественной оценки локальной и глобальной сократимости в покое и на фоне стресс-теста. Все более часто применяется визуализация коронарных артерий для оценки скоростей кровотока в зоне стеноза в покое, а также коронарного резерва на фоне нагрузки. Протокол стрессэхокардиографии расширен за счет оценки параметров, не связанных с сократимостью левого желудочка. Для повышения диагностической ценности стресс-эхокардиографию дополняют ультразвуковым исследованием сонных артерий. Описанные нововведения уже нашли или находят свое место в повседневной клинической практике. В настоящей статье приводится обзор современного состояния эхокардиографии при ишемической болезни сердца.

Ключевые слова:
эхокардиография, ишемическая болезнь сердца, коронарный кровоток, деформация миокарда, echocardiography, coronary artery disease, coronary artery flow, myocardial strain

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Contemporary role of echocardiography in coronary artery disease (a pictorial review)

Echocardiography is an actively developing modality that plays a key role in the diagnosis of coronary artery disease (CAD). In recent years, the important changes occurred in the examination protocols and analysis methods of resting and stress echocardiography in patients with CAD. Along with the standard visual analysis of wall motion, the speckle tracking mode is widely used to quantify local and global contractility when the resting or stress echocardiography is performed. Coronary artery imaging is increasingly used to assess blood flow velocities across stenosis at rest, as well as coronary flow reserve during the stress test. The stress echocardiography protocol has been expanded by including several parameters unrelated to left ventricular contractility. To increase the diagnostic value of stress echocardiography, some authors have suggested to combine it with a focused ultrasound examination of the carotid arteries. The described innovations have already found or are finding their place in everyday clinical practice. This article provides an overview of the current state of echocardiography use in patients with CAD.

Keywords:
эхокардиография, ишемическая болезнь сердца, коронарный кровоток, деформация миокарда, echocardiography, coronary artery disease, coronary artery flow, myocardial strain