Segmental Systolic Function Research Articles

P379 A BIG MASS AROUND THE HEART: SHOULD I BE WORRIED?

Abstract Lipomas account for about 10% of all cardiac tumors and symptoms are often secondary to the compression of cardiac chambers and the consequent hemodynamic impact. We report the case of a 76–year–old woman with no cardiological history, undergoing oncological follow–up for breast cancer underwent a left radical mastectomy in 2014, not followed by radiotherapy or chemotherapy, who came to our attention due to the identification at the total–body CT scan of a mediastinal mass. A voluminous intrapericardial formation was detected, with a maximum size of 5.4 x 8.6 cm, characterized by adipose attenuation values at baseline. On examination, the patient was asymptomatic and eupneic, in good hemodynamic compensation, in functional class NYHA I. The ECG showed sinus rhythm with regular atrioventricular and intraventricular conduction without significant alterations in repolarization. On the echocardiogram, the left ventricle appeared of normal size and thickness without alterations in the global and segmental systolic function, EF 65%; the right ventricle was regular in size and contractility; a voluminous pericardial mass of about 8 x 4.5 cm was observed in the inferior, posterior and lateral site, homogeneous, not vascularized, not compressing the cardiac cavities and not determining hemodynamic impact. The patient was then submitted to cardiac MRI which confirmed the suspicion of intrapericardial lipoma. Considering the absence of symptoms, the benign nature of the lesion and the absence of compression on the cardiac structures, we decided not to remove the mass and to continue clinical and radiological follow–up, thus monitoring size and symptoms.

526 ALAGILLE SYNDROME, A CASE REPORT

Abstract Alagille syndrome (AGS) is a dominantly inherited multisystem disorder caused by heterozygous mutations of genes that are components of the Notch signaling pathway. The main clinical manifestations of AGS are intrahepatic bile duct paucity, congenital heart defects involving primarily the pulmonary arteries, butterfly vertebrae, anterior chamber defects of the eye and facial dysmorphism. A male patient of 39 years old came to our observation due to the worsening of dyspnea, cyanosis, dizziness, heartbeat and asthenia for about two years. His cardiological history includes percutaneous pulmonary artery angioplasty in both left and right main pulmonary artery in 1994. In 2012, finding of pulmonary hypertension and diagnosis of Alagille syndrome confirmed by genetic analysis (JAG1 gene), and vasoreactivity testing of the pulmonary circulation was positive. Intrastent restenosis of the right lobar pulmonary artery treated with POBA in 2016. Patient therapy includes, diltiazem 60 mg OD, macitentan 10 mg OD, sildenafil 40 mg TID. Echocardiogram showed: preserved global and segmental systolic function. Minimal mitral valve insufficiency. Dilated right ventricle (RV / LV> 1), ipokinetic. Right atrium of increased size. Mild tricuspid valve insufficiency (VD-AD 20 mmHg). reduced systolic flow acceleration time (80 msec). Inferior vena cava of normal caliber with preserved inspiratory collapse. Indirect signs of pulmonary hypertension. The six minutes walking test showed severe desaturation after only one hundred meters. Right catheterization showed severe pulmonary hypertension (PAPm 63 mmHg). blood gas analysis showed oxygen saturation of 83% in the pulmonary artery. Angiography of the pulmonary arteries showed intrastent restenosis on the left pulmonary artery and fracture of the stent on the right pulmonary artery. For which was performed angioplasty with stent intrastent implantation in the right pulmonary artery. After the procedure there was immediate reduction in pulmonary mean arterial pressure (53 mmHg), a progressive improvement in 02 saturation (88% at discharge) while the echocardiogram after the procedure results unchanged except for the increasing of the systolic flow acceleration time (100 msec). Right catheterization showed a gradient trans-stenosis of 96 mmHg. We performed angioplasty with stent intrastent implantation in the right pulmonary artery. After that we saw a drop in the gradient trans-stenosis (63 mmHg) and a raise in the systolic pressure of the left pulmonary artery. In Conclusion, in this particular population of patients with pulmonary hypertension even if on maximal therapy, the worsening of symptoms should in our opinion be an indication for right cardiac catheterization and angiography of the pulmonary arteries.

Anthracycline-induced cardiotoxicity: From pathobiology to identification of molecular targets for nuclear imaging.

Anthracyclines are a widely used class of chemotherapy in pediatric and adult cancers, however, their use is hampered by the development of cardiotoxic side-effects and ensuing complications, primarily heart failure. Clinically used imaging modalities to screen for cardiotoxicity are mostly echocardiography and occasionally cardiac magnetic resonance imaging. However, the assessment of diastolic and global or segmental systolic function may not be sensitive to detect subclinical or early stages of cardiotoxicity. Multiple studies have scrutinized molecular nuclear imaging strategies to improve the detection of anthracycline-induced cardiotoxicity. Anthracyclines can activate all forms of cell death in cardiomyocytes. Injury mechanisms associated with anthracycline usage include apoptosis, necrosis, autophagy, ferroptosis, pyroptosis, reactive oxygen species, mitochondrial dysfunction, as well as cardiac fibrosis and perturbation in sympathetic drive and myocardial blood flow; some of which have been targeted using nuclear probes. This review retraces the pathobiology of anthracycline-induced cardiac injury, details the evidence to date supporting a molecular nuclear imaging strategy, explores disease mechanisms which have not yet been targeted, and proposes a clinical strategy incorporating molecular imaging to improve patient management.

Strain indicators in the assessment of systolic myocardial function in aboy with hypertrophic cardiomyopathy: a case report

Purpose: This article is about an unusual clinical case of a 14-year-old boy with hypertrophic cardiomyopathy (HCM).Ejection fraction (EF) and shortening fraction (FS) of the left ventricle in children with HCM remain within a normal range for an extended period of time. Therefore, detection of a decrease in segmental myocardial contractility at the initial stage of the disease presents a diagnostic problem.
 Methods: The clinical characteristics of the patient, study results, and analysis of the left ventricular myocardial strain using 2D speckle-tracking mode in an echocardiographic examination are presented.
 Results: A decrease in strain indicators in the anterioseptal, anterior, and anterolateral segments of the left ventricular myocardium and a compensatory increase in the contralateral segments were revealed. This served as an indication to start treatment.
 Conclusions: A decrease in strain indicators in the 2D speckle- tracking mode is most informatively represented by changes in segmental systolic function of the left ventricle at the initial stage of HCM.

Оцінка повздовжньої деформації лівого шлуночка і її зміни при інфаркті міокарда та ішемічній хворобі серця з обструктивним ураженням коронарних артерій

The review provides data on a new method of ultrasound diagnostics – speckle tracking echocardiography in the diagnosis of myocardial infarction and coronary heart disease with obstructive coronary artery lesions, the advantages of the global longitudinal strain (GLS) compared to the existing echocardiographic indicators of global systolic and segmental systolic function. The value of measuring GLS in coronary heart disease is the quantitative detection of wall motion abnormalities, when left ventricular ejection fraction is within normal values and visual assessment does not detect violations of regional contractility. In patients with myocardial infarction without ST-segment elevation, GLS measurement may assist in the selection of patients who need urgent reperfusion therapy. In coronary heart disease, GLS can complement the conventional assessment of wall movement; replace the need for additional non-invasive testing for some patients with suboptimal stress tests. The normal limits of the GLS for various manufacturers of ultrasound scanners and technical characteristics for the correct studying of the GLS are described. The value of the GLS gradually decreases in mild, moderate and severe forms of coronary heart disease, and is the lowest in patients with myocardial infarction with ST segment elevation. The possibilities of detecting infarct-related coronary artery using the amplitude of the segmental strain and the «bull’s eye» diagram in isolated lesions of one of the coronary arteries are described. The analysis of the strain curves is carried out, the characteristics of the strain curve in normal conditions and in ischemia are presented. The probable signs of ischemia are the phenomena of early systolic lengthening and postsystolic shortening on the curves of longitudinal deformation. The conditions when the postsystolic contraction on the strain curve is pathological are described. Key words: global longitudinal strain, myocardial infarction, ischemic heart disease, «bull’s eye», early systolic lengthening, postsystolic shortening.

РАЗРАБОТКА И АПРОБАЦИЯ ПРИМЕНЕНИЯ ПЕРФУЗИОННОЙ ОФЭКТ В КОМБИНАЦИИ С ДАЛАРГИНОВОЙ ПРОБОЙ ДЛЯ ВЫЯВЛЕНИЯ ЖИЗНЕСПОСОБНОГО МИОКАРДА У ПОСТИНФАРКТНЫХ БОЛЬНЫХ

Purpose: To develop a functional stress-test with Dalargin used as a pharmacological stress agent and to study its diagnostic capabilities for quantifying the general and segmental systolic function of the left ventricle in patients with IHD using SPECT and echo methods.
 Material and methods: The study comprised 29 male patients with CHD-angina of 2-3 functional classes, studied on 15–25 days (on average 20 ± 2.8 days) after a large-focal myocardial infarction. A fractional step-wise injection of Dalargin was performed with step doses as 0.1 mg / kg (1 ml up to a total of 8 ml, with intervals of 90 seconds, for a total of 12 minutes), in a supine position. After each dose of Dalargin, blood pressure, heart rate, ECG were recorded, and an echocardiographic assessment of hemodynamic parameters and local contractility was carried out. At the peak of the effect of dalargin, 99mTc-Tetrofosmin was administered intravenously (370 – 540 MBq), followed by chest SPECT.
 Results: The optimal dose of dalargin for assessing the contractility of the LV was 0.3 mg/kg. From the data of myocardial perfusion SPECT, at dalargin test, the number of segments with normal regional blood supply increased statistically significantly from 56,0 % to 64,7 %, the number of hypoperfused segments decreased from 41.0% to 33.7% as compared to rest, and the number of non-perfused ones – from 3.0 % to 1.6 %. Spearman’s correlation coefficient between segmental contractility and local perfusion at the top dalargin inotropic effect was high and significant (R=0.67, p<0.01). The sensitivity and specificity of the pharmacological test with intravenous administration of dalargin for prediction of postoperative improvement of perfusion and contractility of the viable myocardium were: sensitivity 78.8 %, specificity 76.4 %, diagnostic accuracy 77.6 %.
 Conclusion. The use of the agonist of the μ - and δ-opioid receptors dalargin as a pharmacological stress-agent at perfusion SPECT and Stress Echocardiography to assess the contractile reserve of a dysfunctional viable myocardium is informative and appropriate. In patients with IHD who have suffered a myocardial infarction and are referred to myocardial revascularization, dalargin can be employed as an effective stress-agent for assessing the reserve of perfusion and contractility of dysfunctional left ventricular myocardium using perfusion SPECT and echocardiography.

Utility of 2-Dimensional Speckle-Tracking Echocardiography to Predict Severity of Coronary Artery Disease in Patients With Non ST-Elevation Acute Coronary Syndrome and Apparent Normal Global and Segmental Systolic Function

Utility of 2-Dimensional Speckle-Tracking Echocardiography to Predict Severity of Coronary Artery Disease in Patients With Non ST-Elevation Acute Coronary Syndrome and Apparent Normal Global and Segmental Systolic Function

MON-404 Reversible Dilated Cardiomyopathy in a Severe Case of Cushing’s Disease

Introduction: Patients with Cushing’s syndrome (CS) present a higher mortality compared with the general population mainly due to cardiovascular and infectious diseases. Major forms of cardiac involvement include left ventricular hypertrophy, myocardial ischemia, and, more rarely, reversible dilated cardiomyopathy. This last condition is not fully understood, but it seems to be related to the direct action of cortisol, promoting increase of myocardial responsiveness to several factors involved in myocardial remodeling. Case report: A 18 yrs-old, male, was admitted with a four years clinical picture of progressive weight gain, moon face with plethora, proximal weakness with muscular atrophy, diffuse cutaneous violaceous striae, depressive symptoms and fragility fractures. Arterial hypertension started three years after. Two months before admission, he presented dyspnea, orthopnea and anasarca. At admission, tachycardia, tachypnea, arterial pressure of 170X100 mmHg, oxygen saturation of 83%, bilateral thoracic crackling, diffuse edema reaching inguinal region and BMI of 38.3 kg/m2. Hormonal analyses confirmed severe ACTH-dependent CS and pituitary MRI disclosed an expansible lesion of 1.6 cm suggestive of macroadenoma. Initial transthoracic echocardiography showed dilated left cavities, normal myocardial thickness but with moderate systolic dysfunction due to diffuse hypokinesia with ejection fraction (EF) of 45%. Patient was submitted to pharmacological approach to treat heart failure (HF) with furosemide, carvedilol, enalapril and spironolactone. Other etiologies for myocardiopathy such as infectious, autoimmune and metabolic diseases were excluded. Successful pituitary surgery was done in November 2016. The patient presented progressive improve of cardiac symptoms after all the treatments but mainly after pituitary surgery. Subsequent echocardiography 15 months after showed normal cardiac cavities, normal left ventricle and myocardial thickness and preserved global and segmental systolic function, EF of 56%. In the last evaluation (two years after surgery), the patient was using oral hydrocortisone twice/day and losartan Conclusion: Dilated cardiomyopathy is an uncommon clinical morbidity of CS. However, the immediate recognition of this condition and its effective treatment including control of hypercortisolism may reverse this life-threatening clinical condition

Anthracycline induced inconsistent left ventricular segmental systolic function variation in patients with lymphoma detected by three-dimensional speckle tracking imaging.

Chemotherapy contained anthracycline inevitably cause declines of cardiac function. This study evaluated the deterioration of left ventricular segmental systolic function in patients with lymphoma received anthracycline chemotherapy detected by echocardiographic three dimensional speckle tracking imaging (3D-STI). Sixty patients with newly diagnosed diffuse large B-cell lymphoma who received R-CHOP chemotherapy were enrolled. Three dimensional left ventricular global longitudinal strain (3D-GLS), three dimensional left ventricular global circumferential strain (3D-GCS) and three dimensional left ventricular longitudinal strain of different left ventricular segments (3D-LS) were measured by 3D-STI at baseline, after the completion of two cycles and four cycles of the regimen respectively. Compared with baseline, 3D-GLS reduced significantly after four cycles of anthracycline therapy (P < 0.001), while 3D-GCS showed no significant variation during the whole procedure (all P > 0.05). For individual segment, LS of apical anterior and septal walls decreased significantly after two cycles of chemotherapy (all P < 0.05). After four cycles of treatment, 3D-LS of the mid-ventricular level (all P < 0.05), apical level (all P < 0.05) and apex (P < 0.05) worsened. Serum hs-cTnT levels increased after anthracycline exposure (P < 0.05) and Serum hs-cTnT levels were correlated with 3D-GLS at the end of four cycles (r = 0.12, P = 0.03). Mean values of involved segmental 3D-LS of two and four cycles were both correlated with serum hs-cTnT levels at the end of both two and four cycles (r = 0.368, P = 0.041; r = 0.79, p < 0.001). 3D-STI evaluation of the LV provides an understanding of the segmental impairment of LV wall and the possible process of LV impairment in lymphoma patients after anthracycline chemotherapy.

GW29-e0399 Anthracycline induced inconsistent left ventricular segmental systolic function injury in patients with lymphoma detected by three dimensional speckle tracking imaging

GW29-e0399 Anthracycline induced inconsistent left ventricular segmental systolic function injury in patients with lymphoma detected by three dimensional speckle tracking imaging

P1256Anthracycline induced inconsistent left ventricular segmental systolic function injury in patients with lymphoma detected by three dimensional speckle tracking imaging

P1256Anthracycline induced inconsistent left ventricular segmental systolic function injury in patients with lymphoma detected by three dimensional speckle tracking imaging

Uso clínico do strain rate na ecocardiografia sob estresse em paciente assintomática com fatores de risco para doença cardiovascular: relato de caso

O ecodopplercardiograma transtorácico é um exame de imagem de ampla aplicabilidade clínica que, apesar do requerimento de grande experiência do operador e de possibilidade de janelas acústicas ruins, permite a obtenção de muitas informações de maneira não invasiva, sem riscos de ionização para o paciente, com baixo custo. Quando realizado sob estresse físico ou farmacológico, torna-se uma opção com apropriada acurácia diagnóstica para investigação de isquemia miocárdica. Dentre os recursos disponíveis, o strain rate tem se mostrado útil na detecção de alterações incipientes da função sistólica segmentar, inclusive em pacientes portadores de hipertensão arterial sistêmica e doença arterial coronária. O presente trabalho demonstra o caso de uma paciente do gênero feminino assintomática que, após a submissão ao ecodopplercardiograma sob estresse farmacológico, apresentou hipertrofia do ventrículo esquerdo e strain rate alterado, mesmo sem alterações segmentares de motilidade miocárdica.

Longitudinal 2D strain can help diagnose coronary artery disease in patients with suspected non-ST-elevation acute coronary syndrome but apparent normal global and segmental systolic function

BackgroundThe clinical work-up of patients presenting with chest pain is a diagnostic challenge. We investigated the diagnostic performance of global (GLS) and territorial (TLS) longitudinal strain to predict coronary artery disease (CAD) in patients presenting with suspected non-ST-segment elevation acute coronary syndrome (NSTE-ACS) but apparent normal global and regional systolic function. Methods150 consecutive suspected NSTE-ACS patients were initially screened for inclusion ; 58 patients with normal LVEF (≥55%) and WMSI (=1) were prospectively enrolled. Speckle-tracking echocardiography was performed on admission and all the patients underwent coronary angiography. CAD was defined as the presence of stenosis of >50%. ResultsCAD was present in 33 patients (57%). LVEF was 60.7±4.6% in group 1 (CAD) and 61.1±5.0% in group 2 (no CAD). Global longitudinal strain (GLS) was altered in group 1 (−16.7±3.4%) as compared to group 2 (−22.4±2.9%, p<0.001). ROC curve analysis showed a high diagnostic value of GLS for the prediction of CAD (AUC=0.92 [0.84–1.00], p=0.0001). TLS was able to discriminate between coronary stenosis in the LAD, LCX or RCA. ConclusionsLongitudinal 2D strain has a good diagnostic value and can efficiently localize the culprit lesion in patients presenting with NSTE-ACS but apparent normal global and regional systolic function.

Assessment of right ventricular function in patients with right ventricular overload using real-time three-dimensional echocardiography

Objective To evaluate global and segmental right ventricular (RV) systolic functions in patients with excessive volume or pressure load using real-time three-dimensional echocardiography(RT-3DE). Methods Forty-five patients with RV volume overload, 45 patients with RV pressure overload and 45 healthy subjects were underwent RT-3DE. RV global and segmental (inflow, body, outflow) end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and ejection fraction (EF) were analyzed with TomTec software. The correlations between EF with the three-dimensional method and two-dimensional parameters including right ventricle systolic pressure(RVSP) were discussed. Results Global EDV and ESV increased significantly in both patient groups compared with controls (all P 0.05). Compensated increase of SV was found in sixty percent of patients with volume overload but none with pressure overload (P<0.05). Global EF decreased significantly in both of patient groups (all P<0.05), which was more significant patients with pressure overload (P<0.05). Different patterns of the regional dysfunction were found among the different RV segments. No correlation was found between RVSP and global or segmental EF in patients with pressure overload. Conclusions RT-3DE could be used to assess global and segmental RV systolic function in patients with pressure and volume overload. Key words: Echocardiography, real-time three-dimensional; Ventricular function, right; Right ventricular overload

Longitudinal deformation of the left ventricle and the left atrium in workers of railway transport with arterial hypertension

The research objective was in studying and evaluating the indicators of longitudinal deformation of the left ventricle and the left atrium in persons with arterial hypertension (AH), and also in persons with risk factors, but without AH, workers of railway transport.Materials and methods. The workers of railway transport under research are: 45 patients with AH, 35 people with risk factors, but without AH and 20 healthy volunteers. All the people under research were exposed the transthoracal echocardiography on ultrasonic Philips iE 33 system (Holland) including two-dimensional impulsive wave tissue Doppler echocardiography.Results. The decrease of a systolic velocity of a fibrous ring of the mitral valve in the region of septal and lateral segments in both groups is observed in comparison with the control. In studied groups deterioration of a diastolic function and significant decline of indicators of global longitudinal deformation of a left ventricle and the left atrium in comparison to healthy people are also registered. Depression of segmental deformation of a left ventricle in both groups has a chaotic character. The more the index of mass of a myocardium of a left ventricle, the lower indicators of global deformation are; the more the index of volume of the left atrium, the lower indicators of deformation of the left atrium are.Conclusion. Depression of diastolic and segmental systolic functions of a left ventricle of workers of railway transport is registered both with AH and without AH, but with risk factors that are reflected in indicators of longitudinal deformation of a left ventricle and a left atrium.

Cardiac systolic regional function and synchrony in endurance trained and untrained females

BackgroundMost studies on cardiac function in athletes describe overall heart function in predominately male participants. We aimed to compare segmental, regional and overall myocardial function and synchrony in female endurance...

41 Longitudinal 2D strain can efficiently diagnose coronary artery disease and localize the culprit lesion in patients with suspected non-ST-elevation acute coronary syndrome but normal global and segmental systolic function

41 Longitudinal 2D strain can efficiently diagnose coronary artery disease and localize the culprit lesion in patients with suspected non-ST-elevation acute coronary syndrome but normal global and segmental systolic function

Left ventricular global dyssynchrony is exaggerated with age

&lt;p&gt;Background and Aim: Total isovolumic time (t-IVT) and Tei index both reflect global left ventricular (LV) dyssynchrony. They have been shown to be sensitive in responding to myocardial revascularization and in predicting clinical outcome in heart failure patients. Since most these patients are senior, determining the exact effect of age on such parameters remains mandatory. The aim of this study was to investigate the effect of age on LV t-IVT and Tei index compared with conventional systolic and diastolic parameters in normal individuals.&lt;/p&gt;&lt;p&gt;&lt;span&gt;Methods: &lt;/span&gt;We studied 47 healthy individuals, mean age 62+/-12 years (24 female), who were arbitrarily classified into three groups: M (middle age), S (seniors), and E (elderly), using spectral Doppler echocardiography and tissue-Doppler imaging. We studied the interrelation between age, LV systolic and diastolic function parameters as well as t-IV [60 – (total ejection time + total filling time) in s/min], and Tei index (T-IVT/ejection time).&lt;/p&gt;&lt;p&gt;&lt;span&gt;Results: &lt;/span&gt;LV ejection fraction was 68+/-6%, E/A ratio 1+/-0.4, filling time 538+/-136ms, ejection time 313+/-26ms, t-IVT 7.7+/-2.6 s/min and Tei index 0.41+/-0.14. Age strongly correlated with t-IVT (r=0.8, p&amp;lt;0.001) and with Tei index (r=0.7, p&amp;lt;0.001) but not with QRS duration. Age also correlated with E/A ratio (r=-0.6, p&amp;lt;0.001), but not with global or segmental systolic function measurements. Mean values for t-IVT were 5.5 (95% CI, 4.6-6.3 s/min) for M, 6.9 (95% CI, 6.0-7.8 s/min) for S and 9.5 (95% CI, 8.4-10.6 s/min) for E groups. The corresponding upper limit of the t-IVT 95% normal CI (calculated as mean +/-2SD) for the three groups was 8.3 s/min, 10.5 s/min and 14.5 s/min, respectively. The upper limit of normal t-IVT 95% CI was significantly shorter in the S compared with the E group (p=0.001). T-IVT correlated with A wave (r=0.66, p&amp;lt;0.001), E/A ratio (r=-0.56, p&amp;lt;0.001), septal e’ (r=-0.49, p=0.001) and septal a’ (r=0.4, p=0.006), but not with QRS.&lt;/p&gt;&lt;p&gt;&lt;span&gt;Conclusion: &lt;/span&gt;In normals, age is associated with exaggerated LV global dyssynchrony and diastolic function disturbances, but systolic function remains unaffected. The strong relationship between age and t-IVT supports its potential use as a marker of global LV dyssynchrony. In addition, variations in the upper limit of normal values, particularly in the elderly may have significant clinical applications in patients recommended for CRT treatment.&lt;/p&gt;

IMPACT OF THE ANTIVIRAL THERAPY ON CARDIAC HEMODYNAMICS IN PATIENTS WITH CHRONIC VIRAL HEPATITIS

Aim. To study the effect of antiviral therapy (AVT) on some cardiac hemodynamic parameters in patients with chronic viral hepatitis (CVH). Material and methods. Segmental systolic and diastolic functions of the ventricles as well as global diastolic function were evaluated in 25 patients with CVH by pulsed tissue Doppler mapping and by the method of Doppler echocardiography, respectively. The blood flow speed and diameter of blood vessels in liver were determined by ultrasound Doppler. Cardiac hemodynamics was examined in all patients before and after AVT with interferon in combination with ribavirin with formation of persistent virological response. Healthy people (n=19) were included into control group. Results. Reduction in atrial and ventricular sizes, decrease in left ventricular mass, improvement of systolic function of both ventricles, as well as diastolic function of the left ventricle were found in patients with CVH after specific treatment. Reduction in hepatic arterial and portal blood flow speed and a total number of heart rhythm disorders were also observed. Therefore AVT in patients with CVH shows a positive impact on cardiac hemodynamics. Medium-strength correlation (r=0.31; p<0.05) was identified between Еm speed at fibrous ring of mitral valve and high viral load. Strong correlation (r=0.81; p<0.05) was also found between portal vein diameter and Sm speed at fibrous ring of tricuspid valve. Conclusion. Patients with CVH that do not receive AVT have worse prognosis and indicators of cardiac hemodynamics in comparison with patients who receive specific AVT.

Деформация левого желудочка и левого предсердия у работников железнодорожного транспорта c артериальной гипертензией

The research objective was in studying and evaluating the indicators of longitudinal deformation of the left ventricle and the left atrium in persons with arterial hypertension (AH), and also in persons with risk factors, but without AH, workers of railway transport.Materials and methods. The workers of railway transport under research are: 45 patients with AH, 35 people with risk factors, but without AH and 20 healthy volunteers. All the people under research were exposed the transthoracal echocardiography on ultrasonic Philips iE 33 system (Holland) including two-dimensional impulsive wave tissue Doppler echocardiography.Results. The decrease of a systolic velocity of a fibrous ring of the mitral valve in the region of septal and lateral segments in both groups is observed in comparison with the control. In studied groups deterioration of a diastolic function and significant decline of indicators of global longitudinal deformation of a left ventricle and the left atrium in comparison to healthy people are also registered. Depression of segmental deformation of a left ventricle in both groups has a chaotic character. The more the index of mass of a myocardium of a left ventricle, the lower indicators of global deformation are; the more the index of volume of the left atrium, the lower indicators of deformation of the left atrium are.Conclusion. Depression of diastolic and segmental systolic functions of a left ventricle of workers of railway transport is registered both with AH and without AH, but with risk factors that are reflected in indicators of longitudinal deformation of a left ventricle and a left atrium.