Objective. Improvement of the ultrasound diagnostics of heart global remodeling in chronic heart failure with a reduced ejection fraction (HFrEF) of the left ventricle (LV).

Materials and methods. In 2017—2018 a clinical and instrumental examination of 146 patients aged 40—86 years was performed. Inclusion criteria: sinus rhythm, essential arterial hypertension (AH), chronic coronary heart disease (CHD), past history of LV myocardial infarction, CHF. Serum levels of the N-terminal precursor of the cerebral natriuretic peptide (NT-proBNP) were determined in the patients. Transthoracic echocardiography was performed using a Siemens Acuson S1000 ultrasound machine (Germany).

Results. LV systolic dysfunction, LV operative stiffness >0.26 mm Hg/ml, elevated of LV filling pressure and LV diastolic dysfunction types II and III are determined to be the leading structural and functional abnormalities that have the greatest specific effect on the formation of HFrEF in patients with essential AH, CHD and sinus rhythm. An elevated  LV filling pressure is the leading hemodynamic mechanism and marker of CHF progression. The developed prognostic ultrasonic criteria for global heart remodeling in HFrEF demonstrate high levels of reliability — sensitivity and specificity, which makes it possible to recommend them for use in practical health care.

Conclusion. The established patterns and developed prognostic criteria allow us make scientifically substantiated targeted ultrasound diagnostics of global heart remodeling in HFrEF.