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Оценка деформационных характеристик миокарда технологией двухмерного стрейна у больных с острым инфарктом миокарда с подъемом сегмента ST

Оценка деформационных характеристик миокарда технологией двухмерного стрейна у больных с острым инфарктом миокарда с подъемом сегмента ST

Abstract

Background. The aim of the article is to determine the deformation characteristics using the method of two-dimensional strain in patients with acute myocardial infarction with ST-segment elevation (STEMI) after reperfusion therapy. Materials and methods. 16 patients with STEMI (group 1) and 20 healthy volunteers in the 2nd control group participated in the study. According to the assessment of revascularization effectiveness based on the TIMI scale the patients with STEMI were divided as follows: group 1 included patients with good angiographic results (TIMI 2-3), the 2nd group with unsatisfactory effect of reperfusion (TIMI 0-1). Results. The parameters of the universial myocardial deformation in patients with TIMI 2-3 were higher than the similar data of patients with TIMI 0-1, where the longitudinal and circular deformation of the left ventricle (51 and 36 %) were the most affected. In patients with good angiographic results after stenting there was observed an increase in universal longitudinal and radial deformation rates, in case of unsatisfactory only radial one increased. Conclusion. The technique of two-dimensional strain is an affordable and promising ultrasonic method that significantly extends the capabilities of non-invasive dynamic monitoring of the processes of pathological LV remodeling in patients with acute myocardial infarction. Using this technique the authors revealed a high dependence of myocardial deformation characteristics on the reperfusion therapy effectiveness in patients with STEMI.

Актуальность и цели : определить особенности деформационных характерстик с помощью метода двухмерного стрейна у больных острым инфарктом миокарда с подъемом сегмента SТ (ИМпSТ) после проведения реперфузионной терапии. Материалы и методы. В исследование включено 16 пациентов с ИМпST (первая группа) и 20 здоровых добровольцев (контрольная группа). С учетом оценки эффективности реваскуляризации по шкале ТIМI больные ИМпSТ были разделены следующим образом: в первую группу вошли пациенты с хорошим ангиографическим результатом ( ТIМI 2-3), во вторую группу - с неудовлетворительным реперфузионным эффектом ( ТIМI 0-1). Результаты. Показатели глобальной деформации миокарда у больных с ТIМI 2-3 превышали аналогичные данные больных с ТIМI 0-1, где в наибольшей степени страдали продольная и циркулярная деформации левого желудочка (51 и 36 %). У больных с хорошим ангиографическим результатом после стентирования отмечалось увеличение глобальной продольной и радиальной скоростей деформации, с неудовлетворительным - только радиальной. Выводы. Технология двумерного оценивания пятен представляет собой доступную и перспективную ультразвуковую методику, которая существенно расширяет возможности неинвазивного динамического наблюдения за процессами патологического ремоделирования левого желудочка у больных острым инфарктом миокарда. С помощью данной методики выявлена высокая зависимость деформационных характеристик миокарда при ИМпSТ от эффективности реперфузионной терапии.

Keywords

ОСТРЫЙ ИНФАРКТ МИОКАРДА С ПОДЪЕМОМ СЕГМЕНТА ST, РЕПЕРФУЗИОННАЯ ТЕРАПИЯ, ДВУХМЕРНЫЙ СТРЕЙН, ДЕФОРМАЦИОННЫЕ ПОКАЗАТЕЛИ МИОКАРДА ЛЕВОГО ЖЕЛУДОЧКА, ПРОДОЛЬНАЯ ДЕФОРМАЦИЯ МИОКАРДА, ЦИРКУЛЯРНАЯ ДЕФОРМАЦИЯ МИОКАРДА, РАДИАЛЬНАЯ ДЕФОРМАЦИЯ МИОКАРДА, ФЕНОМЕН НЕВОССТАНОВЛЕННОГО КРОВОТОКА, ACUTE MYOCARDIAL INFARCTION WITH ST-SEGMENT ELEVATION (STEMI)

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
gold