Objective. The aim of the study is to develop criteria for ultrasound diagnosis of the heart global remodeling in case of an increased left ventricle (LV) end diastolic pressure (EDP).
Materials and methods. In 2017—2018, a clinical and instrumental examination of 303 patients aged 40—86 years was performed. Inclusion criteria: sinus rhythm, essential arterial hypertension, chronic coronary heart disease, past myocardial infarction, chronic heart failure (CHF). Exclusion criteria: primary mitral regurgitation, mitral stenosis, mitral valve repair or prosthetics, congenital heart defects. Transthoracic echocardiography was performed on a Siemens Acuson S1000 ultrasound machine (Germany).
Results. The ultrasound markers for formation of high types of the LV diastolic dysfunction (DD), CHF progression, and increased LV EDP are determined to be (Ardur–Adur )>32 ms, the peak velocities of late diastolic movement of mitral fibrous ring according to tissue Doppler sonography (TD) а¢septal£9 cm/s and a¢lateralis£11 cm/s. An increased LV EDP is associated with the LV myocardial mass index > 133.9 g/m2, the LV operative stiffness >0.24 mm Hg/ml, the left atrial volume index (LA) > 35.7 ml/m2. The peak velocities a¢septal£11 cm/s and a¢lateralis£11 cm/s are the prognostic factors for formation of the left auricle dilatation due to an EDP increase in case of the LV DD.
Conclusion. An elevated LV EDP is the hemodynamic and echocardiographic marker of the LV diastolic dysfunction and the CHF development and progression.Ключевые слова:
Автор(ы): O. M. Zherko