The use of methods of spatial displacement of the myocardial structure (speckle tracking) to determine the indications for coronary angiography in patients suffering from coronary heart disease

Abstract

The indicators of global and segmental longitudinal deformation of the left ventricular myocardium are presented and analyzed in patients suffering from coronary heart disease. The latter, as before, remains one of the urgent diseases of the circulatory system. To verify and determine management tactics for patients suffering from coronary heart disease, coronary angiography is performed. Indications for its implementation are based on the results of exercise tests, in particular, stress echocardiography. However, its implementation can be difficult due to poor visualization of the walls of the left ventricle, and the conclusion is not without subjectivity. One of the modern methods for assessing the contractility of the left ventricular myocardium, both global and segmental, is the spatial displacement of the myocardial structure (speckle-tracking- echocardiography). The technique automatically calculates the longitudinal deformation of the myocardium, expressed as a percentage of the initial values. It was found that the global and segmental longitudinal deformation of the left ventricular myocardium in the majority of the evaluated segments in the examined patients did not differ before loading. When conducting a stress test, the exact opposite dynamics of changes in the parameters of the global and segmental longitudinal deformation of the left ventricular myocardium is observed. So, in patients with a high risk of complications of coronary heart disease, a decrease in these indicators was observed, in patients without a risk of complications, on the contrary, their increase was observed, which indicates an increase in myocardial contractility during physical exertion. It was revealed that the indicator of global longitudinal deformation of the left ventricular myocardium is highly informative. The lower value of the decrease in the global longitudinal deformation of the left ventricular myocardium was calculated, which can serve as an additional indication for coronary angiography.