2017


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2017/№2

Opportunities of the echocardiography in prognosis of the left ventricular diastolic dysfunction in patients with hypertension

Obrezan A. G.1, Perutskiy D.N.2, Perutskaya E.A.2
1 – Federal State Budgetary Educational Institution of Higher Education "Saint-Petersburg State University ", 7/9 University Embankment, St.-Petersburg, 199034
2 – Regional State Budgetary Institution of Health Care "Saint Ioasaph Belgorod Regional Clinical Hospital", Nekrasova 8/9, Belgorod 308007

Keywords: chronic heart failure, ejection fraction, stress echocardiography, myocardium deformations

DOI: 10.18087/rhj.2017.2.2333

Aim. To develop a diagnostic algorithm for detection of patients at high risk for impairment of LV diastolic function within 12 months of observation among patients with chronic heart failure and preserved ejection fraction. Materials and methods. 110 patients with essential hypertension and clinically significant chronic heart failure were included into this study. The inclusion criterion was LV diastolic dysfunction without evidence for coronary stenosis. A standard clinical and laboratory evaluation and echocardiography with measurement of three-dimensional longitudinal strain were performed for all patients. Stress echocardiography with treadmill exercise was performed for all patients using an expert class apparatus, Toshiba Artyda, to measure parameters of the diastolic function. In 12 months, the examination was repeated for all patients. Results. Stress echocardiography provided early signs of structural and functional changes in the cardiovascular system, including increased left ventricular filling pressure during the exercise. The Е/е’ value measured during stress echocardiography and the 3D GLS were prognostic markers for impaired LV diastolic function. An Е/е’ value exceeding 12.1 during the baseline stress-EchoCG indicated impairment of the LV diastolic function at 12 months of follow-up with sensitivity and specificity of 100% and 96.2%, respectively. For 3D GLS values exceeding –12.86%, sensitivity and specificity for prediction of impaired diastolic function were 96.9% and 90.6%, respectively. Conclusion. Using stress EchoCG and parameters of myocardial deformation allows improving diagnostics in patients with diastolic dysfunction and chronic heart failure with preserved ejection fraction.
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Obrezan A. G., Perutskiy D. N., Perutskaya E. A. Opportunities of the echocardiography in prognosis of the left ventricular diastolic dysfunction in patients with hypertension. Russian Heart Journal. 2017;16 (2):135–142

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