O‘zbekiston кardiologiyasi Ҷилди 2 № 2 (2025) · Саҳифаҳои 122-132
Speckle-tracking echocardiography in assessing staged cardiac remodeling in ischemic heart failure
Бекметова, Ф, Фозилов, Х, Бекбулатова, Р, Хошимов, Ш, Оринбаев, Ш, Bekmetova, Feruza, Fozilov, Xurshid, Bekbulatova, Regina, Xoshimov, Shavkat, Orinbaev, Sherzod, Bekmetova, Feruza, Fozilov, Khurshid, Bekbulatova, Regina, Khoshimov, Shavkat, Orinbaev, Sherzod
Аннотатсия
Aim. To assess the features of global staged remodeling of the heart chambers in patients with ischemic chronic heart failure, depending on the degree of left ventricular ejection fraction (LVEF) reduction, using two-dimensional echocardiography with myocardial deformation analysis. Materials and methods. The study included 96 patients with a confirmed diagnosis of CHF according to current criteria. Patients were divided into three groups based on LVEF: Group I – LVEF >50% (n=46, preserved systolic function); Group II – LVEF 40-49% (n=24, mildly reduced systolic function); Group III – LVEF <40% (n=26, significantly reduced systolic function). Global longitudinal strain (GLS) of the LV was significantly lower in patients with reduced ejection fraction. Results. In the group with LVEF >50%, the mean GLS was 17.0 ± 2.8%, while in those with LVEF 40–49% and <40%, values decreased to 12.6 ± 2.1% and 9.4 ± 2.2%, respectively (p < 0.001). A similar trend was observed for GLS measured in 4-, 2-, and 3-chamber views. These findings indicate high sensitivity of GLS to impaired myocardial contractility and confirm its clinical significance in assessing LV functional status.The assessment of LA function using 2D speckle-tracking echocardiography in the reservoir, conduit, and contractile phases also revealed a significant decrease in absolute parameters: LASr (reservoir phase) - 35.5 ± 8.3% (LVEF >50%) →17.8 ± 11.2% (LVEF <40%), *p* < 0.001; LASct (conduit phase) - 17.6 ± 5.4% → 8.8 ± 6.5%, *p*< 0.001; LAScd (contractile phase) - 18.7 ± 5.9% → 8.7 ± 4.6%, *p* < 0.001. In patients with LVEF>50%, RV longitudinal strain parameters were highest (RVFWLS - 21.3 ± 4.0%; RV GLS - 18.1 ± 3.2%), while in LVEF 40–49%, they decreased (19.9 ± 2.8% and 16.0 ± 2.7%, respectively), and in LVEF <40%, the most pronounced decline was observed (RVFWLS: 14.0 ± 4.1%; RV GLS: 10.5 ± 3.1%), with significant intergroup differences (p=0.001). Conclusion. Patients with ischemic CHF exhibit progressive remodeling of all heart chambers (LV, LA, and RV), with worsening functional impairment as LVEF declines. LV global longitudinal strain (GLS), as well as LA (LASr, LASct, LAScd) and RV (RVFWLS, RV GLS) deformation parameters, demonstrate high sensitivity to hemodynamic changes and may serve as early markers of CHF progression. Speckle-tracking echocardiography is an informative non-invasive method for assessing subclinical myocardial dysfunction and may be useful for risk stratification and therapy monitoring in patients with varying degrees of CHF severity.
Speckle trackingGlobal Longitudinal StrainChronic Heart Failureспекл-трекингглобальная продольная деформацияхроническая сердечная недостаточностьspekl-trekingglobal uzunlamasına deformatsiyasurunkali yurak yetishmovchiligi
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