Abstract: Aim: to study the contractility of left ventricle (LV) and left atrium (LA) by speckle tracking imaging (STI), vector analysis and the diagram method in patients with mitral regurgitation (MR). Materials and methods: we examined 63 patients (39 males, 24 females), mean age 53±11 years with 3-4 degree MR and control group of 26 healthy volunteers (15 males, 11 females), mean age 39±7 years. Transthoracic echocardiography was performed by a standard technique at rest. Sizes and volumes of LV, LA, ejection fraction (EF), degree of MR, pulmonary artery (PA) pressure were evaluated. LV and LA images were analyzed by STI with LV global longitudinal strain (GS), peak atrial longitudinal (PALS) and contraction strain (PACS), and by vector analysis of myocardial displacement and «Flow-Volume» diagrams. Rates of volume change in LV (dVol/dt) and LA (LAdVol/dt), rates of long axis change in LV (dLA/dt) and LA (LAdLA/dt), LA long axis size (LA) were calculated in systole (reservoir phase) and diastole (conduit phase). Statistical analysis (Statistica,10.0; JMP). Results: left heart sizes and volumes, PA pressure compared to the norm were increased(p<0,(0)), but the EF was preserved. GS and PACS in patients with MR was normal, but PALS was reduced (p<0,(0)), while dVol/dt and LAdVol/dt were increased and shown in «Flow-Volume» diagrams. But, dLA/dt was normal, LAdLA/dt was reduced in the conduit phase, LA size was increased (p<0,(0)). Conclusion: STI, vector analysis and diagram method parameters are the criteria for efficiency of LV and LA function in patients with MR. References 1. Nishimura R. A., Otto C. M., Bonow R. O., et.al. 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease. Circulation. 2017; 135: e1159-e1195. 2. Voigt, J.U., Pedrizzetti G. Definitions for a common standard for 2D speckle tracking echocardiography: consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. J.U. Voigt, G. Pedrizzetti, P. Lysyansky [et al.] Eur. Heart J. Cardiovasc. Imaging. 2015; 16 (1): 1-11. 3. Kalinin A., Alekhin M. N., Bakhs G. idr. Otsenka deformatsii levogo predserdiya u bolnyh arterialnoy gipertoniey i aortalnym stenozom s razlichnoy stepenyu gipertrofii levogo zheludochka [Left atrial deformation assessment in patients with arterial hypertension and aortic stenosis with varying degrees of left ventricle hypertrophy]. Ter. arhiv. 2012; 4: 23-29 [In Russ]. 4. Pavlyukova E.N., Kuzhel D.A., Matyushin G.V. Funktsiya levogo predserdiya: sovremennye metody otsenki i klinicheskoe znachenie [Left atrial function: new assessment methods and clinical significance]. Ratsionalnayafarmakoterapiya v kardiologii. 20l7;13(5):675-683 [ In Russ]. 5. Sokhibnazarova V.H.,Saidova M.A., Tereschenko S.N. Primenenie novykh ekhokardiograficheskikh tehnologiy nedopplerovskogo izobrazheniyamiokarda v dvumernom i trekhmernom rezhimakh u bolnykh KHSN s sokhrannoy i snizhennoy frakciey vybrosa levogo zheludochka [Application of new echocardiographic technologies of non-doppler myocardial images in 2D and 3D modes in patients with chronic heart failure with preserved and reduced ejection fraction]. Evraziyskiy kardiologicheskiy zhurnal. 2017; 2: 42-47 [In Russ]. 6. Cameli M., Incampo E., Mondillo S., Left atrial deformation: Useful index for early detection of cardiac damage in chronic mitral regurgitation, IJC Heart&Vasculature. 2017; 17: 17-22. 7. Sandrikov V.A., Kulagina T. Yu., Ivanov V.A. i soavt. Fenomenologicheskie zakonomernosti v otsenke funkcii levogo zheludochka serdca pri nedostatochnosti mitralnogo klapana [Phenomenological regularities in left ventricle function assessment at mitral valve insufficiency]. Zh. Kardiologija. 2018; 58(1): 32-40 [In Russ]. 8. Pathan F., Elia N., Nolan M.T., et.al. Normal ranges of left atrial strain by speckle-tracking echocardiography: a systematic review and meta-analysis. J. Am Soc. Echocar- diogr. 2017;30(1): 59-70. 9. Leischik R., Littwitz H., Dworrak B. Echocardiographic Evaluation of Left Atrial Mechanics: Function, History, Novel Techniques, Advantages, andPitfalls. 2015; 1-8. 10. Debonnaire P, Leong D. P, Witkowski T. G. et al.Left atrial function by two-dimensional speckle-tracking echocardiography in patients with severe organic mitral regurgitation: association with guidelines-based surgical indication and postoperative (long-term) survival. Journal of the American Society of Echocardiography. 2013.26 (9): 1053-1062.
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Abstract: The article gives account of coronary stenting impact on the dynamics of left ventricle index. The study covered 94 postinfarction patients, including 80 men and 14 women. Among them 52 patients with Q-forming myocardium infarction and 42 with non-Q myocardium infarction were observed. 1 3 patients that suffered Q-forming myocardium infarction didn't show any segment contractility disorders (group 1), while 39 showed contractility disorders (group 2). The analysis revealed that index improvement of the left ventricle is observed in the 1st group in 77% cases after stenting, while the 2nd group shows no improvements. Among the 2nd group of patients the full recovery is observed in 21% cases, the partial recovery - in 46% and 1 3% didn't overcome any dynamics. The EchoCG study performed on 42 patients revealed that 31 men have no segmental activity disorders (group 3) and 1 1 suffered segmental activity disorder (group 4). Stenting procedure improved the myocardium function in the 3rd group in 65% cases. In the long prospect 1 0 patients of the 4th group fully recovered their myocardium function and only 1 man showed no dynamics in contractility improvement. Taking into consideration what has been said one can be sure that EchoCG proves to be an effective method of valuing the left ventricle function improvement before and after coronary stenting. References 1. Бокерия А.А. Современное общество и сердечно-сосудистая хирургия. Тезисы докладов V Всероссийского съезда сердечно-сосудистых хирургов. М., 1999; 3-6. 2. Чазов Е.И. Проблемы борьбы с сердечно-сосудистыми заболеваниями. Кардиология. 1973; 2: 5-10. 3. Белов Ю.В., Вараксин В.А. Современное представление о постинфарктном ремоделировании левого желудочка. Русский медицинский журнал. 2002; 10: 469-471. 4. Самко А.Н. Применение интракоронарных стентов ДЛЯ лечения больных ишемической болезнью сердца. Русский медицинский журнал. 1998; 6(14): 923-927. 5. Мазур Н.А. Эффективные и безопасные методы лечения больных хронической ишемической болезнью сердца. Русский медицинский журнал. 1998; 6(14): 908-913. 6. Петросян Ю.С., Зингерман Л.С. Классификация атеросклеротических изменений коронарных артерпи. Тезисы докл. 1 и 2 Всесоюзных симпозиумов по современным методам селективной ангиографии и их применение в клинике. М., 1973; 16. 7. Петросян Ю.С., Иоселиани Д.Г. О суммарной оценке состояния коронарного русла у больных ишемической болезнью сердца. Кардиология. 1976; 12(16): 41-46. 8. Петросян Ю.С., Шахов Б.Е. Коронарное русло у больных с постинфарктной аневризмой левого желудочка сердца. Горький. 1983; 17-20. 9. Bourdillon P.D.V, Broderick T.M., Sawada S.G, Armstrong WE, Ryan., Dillon J.C., Fineberg N.S., and Feigenbaum H.: Regional wall motion index for infarct and noninfarct regions after reperfusion in acute myocardial infarction: Comparison with globalwall motion index./. Am. Soc. Echocardiogr. 1989; 2: 398. 10. Фейгенбаум Харви «Эхокардиография». М.: Видар. 1999; 115-119. 11. Otto СМ., Pearlmann A.S. Textbook of clinical echocardiograph.
Abstract: Despite the fact that so far in the literature, many cases of endovascular closure of paravalvular leak (PVL), this type of intervention is unusual and is associated with a complex technical issues. In addition, the majority of publications devoted to the correction of mitral and aortic PVL, while the description of the closing of the tricuspid valve (TV) PVL are rare. Below is a description of our first experience of endovascular correction of TV PVL in 54 years ole patient, who underwent TV repair with «Neokor-32» - supporting ring as a correction of atrial septal defect, TV insufficiency One year after surgery the patient reported a decrease in physical activity tolerance. Echocardiography diagnosed hemodynamically significant PVL of TV, 6mm size with leakage between the left ventricle and the right atrium and formation of pulmonary hypertension. PVL was successfully treated by endovascular correction with using of device for closure of ventricular septal defect. References 1. Galea A. et al. Practical applications of digital tomosynthesis of the chest. Clinical radiology. 2014; 69(4): 424-430. 2. de Koste J. R. S. et al. Digital tomosynthesis (DTS) for verification of target position in early stage lung cancer patients. Medical physics. 2013; 40(9): 091904. 3. Dobbins III J. T. et al. Digital tomosynthesis of the chest for lung nodule detection: interim sensitivity results from an ongoing NIH-sponsored trial. Medical physics. 2008; 35(6): 2554-2557. 4. Vikgren J. et al. Comparison of Chest Tomosynthesis and Chest Radiography for Detection of Pulmonary Nodules: Human Observer Study of Clinical Cases 1. Radiology. 2008; 249(3): 1034-1041. 5. Quaia E. et al. Digital tomosynthesis as a problemsolving imaging technique to confirm or exclude potential thoracic lesions based on chest X-ray radiography. Academic radiology. 2013; 20(5): 546-553. 6. Jung H. N. et al. Digital tomosynthesis of the chest: utility for detection of lung metastasis in patients with colorectal cancer. Clinical radiology. 2012; 67(3): 232-238. 7. Nikitin M. M. Possibilities of digital tomosynthesis in the diagnosis of various forms of pulmonary tuberculosis. REJR. 2016; 6 (1): 35-47. [In Russ]. 8. F.Kovach F., Zhebek Z. X-ray anatomical basics of lungs’ examinations. Budapest, 1958; 364 p. [In Russ]. 9. Trofimova T. N. ed. Human X-ray anatomy. SPb.: Publishing house SPbMAPO. 2005; 496 p. [In Russ]. 10. Sapin M. R. ed. Human Anatomy. Moscow, M.: Medicine. 2001; 640 p. [In Russ]. 11. Sinelnikov R. D., Sinelnikov Ya. R. Atlas of human anatomy. M.: Medicine. 1996; 344 p. [In Russ]. 12. Kokov L. S., ed. X-ray Atlas of comparative anatomy. M.: Radiology-Press., 2012; 388 p. [In Russ].
Abstract: Aim: was to assess dynamics of strain (S) and strain rate (SR) of longitudinal, circular and radial fibers in patients with left ventricular (LV) aneurysm (LVA) before and in early stages after coronary artery bypass graft (CABG) using Velocity Vector Imaging. Material and methods: in 270 segments LV in patients with LVA, S and SR of LV fibers was analyzed before and after CAB. Also analysis of S and SR was performed in patients with CABG and plastic of the LV (group 1, 144 segments) and in the group with CABG without plastic of the LV (group 2, 126 segments). Results: a function of longitudinal, circular and radial fibers after CABG has improved in all patients. Only SR of radial fibers reached normal. In group 1 was received the positive dynamics from the longitudinal S and SR, and SR circular and radial fibers. In group 2 indicators of function of longitudinal and circular fibers remained without negative dynamics, but positive dynamics is observed only from the SR of the radial fibers. The SR of radial fibers in both groups was normalized. Conclusion: improvement of LV function in all patients is due to the group I. It is important to study the LV function in patients with LVA depending on the type of surgery. References 1. Paramonova T.I., Basylev V.V., Vdovkin A.V., Palkova V.A., Karpuchin V.G. Vliyanie operacij rekonstrukcii levogo zheludochka na funkcional'nye i ob"emnye pokazateli u bol'nyh s postinfarktnoj anevrizmoj. [The impact of operations on the reconstruction of the left ventricle function and volume indices in patients with postinfarction aneurism.] Diagnostic radiology and radiotherapy. 2015; 1(6): 74-81 [In Russ]. 2. Dor V., Di Donato M., Civaya F. Postinfarktnoe remodelirovanie levogo zheludochka: magnitno-rezonansnaya tomografiya dlya ocenki patofiziologii posle rekonstrukcii levogo zheludochka. [Post myocardial infarct remodeling: role of magnetic resonance imaging for the assessment of its pathophysiology after left ventricular reconstruction.] Thoracic and Cardiovascular Surgery. 2014; 3: 14-27 [In Russ]. 3. Chernyavskii A.M., Kareva Yu. E., Denisova M.A.,Efendiev V.U. Problema predoperacionnogo modelirovaniya levogo zheludochka. [The problem of preoperative left ventricular modeling.] Cardiology and Cardiovascular Surgery. 2015; 2: 4-7 [In Russ]. 4. Carasso Sh., Biaggi P., Rakowski H. et al. Velocity Vector Imaging: Standart Tissue - Tracking Results Acquired in Normals - The VVI - Strain Study. Journal of the American Society of Echocardiography. 2012; 25(5): 543-552. 5. Alekhin M.N. Ul'trazvukovye metody ocenki deformacii miokarda i ih klinicheskoe znachenie. [Ultrasound estimation techniques and their clinical significance.] M.: Vidar-M, 2012; 88 p [In Russ]. 6. Rostamzadeh A., Shojaeifard M., Rezaei Y, et al. Diagnostic accuracy of myocardial deformation indices for detecting high risk coronary artery disease in patient without regional wall motion abnormality. Int J Clin Exp Med. 2015; 8(6): 9412-9420. 7. Pavlyukova E.N., Karpov R.S Deformaciya, rotaciya i povorot po osi levogo zheludochka u bol'nyh ishemicheskoj bolezn'yu serdca s tyazheloj levozheludochkovoj disfunkciej. [Deformation, rotation, and axial torsion of the left ventricle in coronary heart disease patients with its severe dysfunction. ] Terapevticeskij arhiv. 2012;9: 11-16 [In Russ]. 8. Lang R.M., Badano L.P, Mor-Avi V., et al. Recommendation for cardiac chamber quantification by echocardiography in adults: an update from the American society of echocardiography and the European association of cardiovascular imaging. 2015; 16: 233-271. 9.
