DOI: https://doi.org/10.22263/2312-4156.2020.4.69
Zherko O.M.1, Shkrebneva E.I.2
Ultrasonic visualization of the right ventricle remodelling in chronic heart failure with preserved ejection fraction
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. 2020;19(4):69-76.
Abstract.
Objectives. To increase diagnostic efficiency of the right ventricle (RV) global remodelling in chronic heart failure with preserved ejection fraction (CHFpEF) based on the development of integrated criteria for its definition according to the findings of transthoracic echocardiography (TTE) and 2D Speckle Tracking echocardiography (STE).
Material and methods. In 2017-2019, a clinical and instrumental study of 246 patients aged 71 [64; 78] years was performed on the basis of the First City Clinical Hospital in Minsk, and 88 patients aged 64.0 [58.0; 70.0] years were studied on the basis of Minsk Scientific-Practical Center of Surgery, Transplantation and Hematology. Criteria for inclusion in the study: sinus rhythm, essential arterial hypertension, chronic coronary heart disease, past myocardial infarction, after which at least six months have passed, chronic heart failure. Exclusion criteria: primary mitral regurgitation, mitral stenosis, mitral valve repair or prosthetics, congenital heart defects, acute and chronic diseases of the kidneys, lungs. TTE and STE were performed on ultrasonic machines Siemens Acuson S1000 (Germany) and Vivid E9 (GE Healthcare, USA), respectively.
Results. The major hemodynamic and functional anomalies in CHFpEF, reflecting LV filling pressure elevation, combined remodelling of the post- and precapillary pulmonary vascular bed and the RV, are the mean pulmonary capillary wedge pressure >8.49 mm Hg, pulmonary vascular resistance >1.68 Wood units, RV systolic pressure > 26.4 mm Hg, tricuspid regurgitation rate >2.42 m/s, RV diastolic dysfunction of types I and II. Anomalies of the RV global and regional systolic and diastolic function according to STE data in CHFpEF are the values of the RV global systolic strain >-19.9%, the RV global index of mechanical dispersion > 50.29 m/s, the RV global post-systolic index >2.17%, the RV early diastolic strain E of the RV basal-septal segment >-4.6%.
Conclusions. The developed complex of diagnostic criteria of the RV global remodelling in CHFpEF possesses high levels of reliability, which enables us to recommend it for use in practical health care.
Key words: transthoracic echocardiography, 2D Speckle Tracking echocardiography, chronic heart failure with preserved ejection fraction, right ventricle.
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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.
