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DOI: https://doi.org/10.22263/2312-4156.2021.2.77

Zherko O.M.1, Shkrebneva E.I.2
Scoring scale for assessing the risk of detecting right ventricle diastolic dysfunction of type II in chronic heart failure
1Belarusian Medical Academy of Post-Graduate Education, Minsk, Republic of Belarus
2Minsk Scientific-Practical Center of Surgery, Transplantation and Hematology, Minsk, Republic of Belarus

Vestnik VGMU. 2021;20(2):77-87.

Abstract.
Odjectives. To develop a scoring scale for assessing the risk of detecting right ventricle (RV) diastolic dysfunction (DD) of type II in chronic heart failure (CHF).
Material and methods. In 2017-2018, a clinical and instrumental examination of 247 patients aged 40-86 years was performed on the basis of Health Care Institution «The 1st City Clinical Hospital» in Minsk, in 2019-2020, 129 patients at the age of 39-84 years were examined in the State Institution «Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology». Study inclusion criteria: sinus rhythm, essential arterial hypertension (AH), chronic ischemic heart disease (IHD), CHF, informed voluntary consent of the patient to participate in the study. Exclusion criteria: primary mitral regurgitation, mitral stenosis, mitral valve repair or replacement, congenital heart defects, acute and chronic diseases of the lungs and kidneys.
Results. The sum of points>52 obtained using a scoring scale that includes scientifically based ultrasound criteria for global cardiac remodelling: RV early diastolic filling index E/eʹ >4.08 (sensitivity (S) 81.1%, specificity (Sp) 56.9%) ‒ 15 points, the amplitude of the systolic displacement of the lateral part of the tricuspid annulus in systole to the apex (TAPSE) ≤20 mm (S 74.1%, Sp 83.3%) ‒ 49 points, pulmonary artery systolic pressure ˃32.6 mm Hg (S 85.2%, Sp 79.5%) ‒ 31 points, indicates a high risk of detecting RV DD of type II in CHF (AUC 0.99, S 93.9%, Sp 100.0%). The reproducibility of the results is shown in an independent examination sample of patients with CHF with preserved left ventricular ejection fraction. (AUC 0.99, S 90.0%, Sp 100%, +PV 100.0%, ‒ PV 34.5% with a cut-off threshold >52).
Conclusions.When using the scale, the score is >52, it is recommended to perform a comprehensive targeted assessment of global cardiac remodelling to determine RV DD of type II in a patient with CHF, complicating essential AH, chronic IHD.
Key words: right ventricular diastolic dysfunction of type II, chronic heart failure, echocardiography, scoring scale.

References

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Information about authors:
Zherko O.M. – Candidate of Medical Sciences, associate professor, head of the Chair of Ultrasound Diagnosis, Belarusian Medical Academy of Post-Graduate Education;
Shkrebneva E.I. – head of the Department of Physiologic Diagnosis, Minsk Scientific-Practical Center of Surgery, Transplantation and Hematology.

Correspondence address: Republic of Belarus, 220013, Minsk, 3-3 P. Brovki str., Belarusian Medical Academy of Post-Graduate Education, Chair of Ultrasound Diagnosis. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Olga М. Zherko.

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