DIAGNOSTIC MARKERS OF RIGHT VENTRICLE SYSTOLIC DYSFUNCTION DEVELOPMENT UNDER CHRONIC HEART FAILURE

Objective. To develop diagnostic markers of the right ventricular (RV) systolic dysfunction development in patients with chronic heart failure (CHF).

Materials and methods. In 2017—2018, а clinical and instrumental examination of 246 patients aged 40–86 years was performed. The patients inclusion in the study was based on the sinus rhythm, essential arterial hypertension values, the chronic ischemic disease, the previous myocardial infarction, CHF presence. The transthoracic echocardiography was performed using a Siemens Acuson S1000 ultrasound machine (Germany).

Results. There was a strong correlation between the RV systolic dysfunction and the NT-proBNP level (r=0.72, p<0.001). The threshold value of NT-proBNP, a prognostic indicator of the RV systolic dysfunction development, had been agreed to be >408 pg/ml (the criterion sensitivity 80.4%, specificity 81.1%). The ultrasound indicators predicting the RV systolic dysfunction development are the following: the LV fraction ejection £50.1% (sensitivity 87.5%, specificity 87.6%), the right atrium end systolic area >18.6 cm2 (sensitivity 76.6%, specificity 63.7%), the tricuspid regurgitation rate >2.65 m/s (sensitivity 83.3%, specificity 62.0%), the hepatic veins filling systolic fraction £50.2% (sensitivity 76.7%, specificity 80.4%), the RV systolic pressure (RVSP) >37.6 mmHg (sensitivity 70.8%, specificity 85.0%), TAPSE/RVSP £0.46 (sensitivity 85.4%, specificity 93.5%).

Conclusion. The criteria developed for predicting the RV systolic dysfunction development in CHF persons have high levels of sensitivity, specificity allowing us recommend them for using during echocardiography.

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Автор(ы): O. M. Zherko