Abstract
Itroduction. Echocardiographic data and new visualization techniques for myocardium - vector velocity
imaging, the Speckle tracking (ST) made it possible to quantify the mechanics of the movement of the heart,
ventricular and atrial function, early diagnosis and monitoring of heart failure treatment. To identify predictors
of heart failure after surgical correction by echocardiography with tissue Doppler (TD) and Speckle
tracking in patients with aortic and mitral valve diseases.
Material and methods. The study involved 144 patients with aortic and mitral diseases: 99 men and 45 women
aged from 18 to 72 years (mean age 46.7+15.08 years).
Patients were examined at baseline before surgery in the early postoperative period (8-14 days) and 12-36
months after the surgical correction of valve diseases. All patients underwent clinical examination, electrocardiography,
echocardiography, tissue Doppler echocardiography, vector velocity imaging, Speckle tracking.
Magnetic resonance imaging (MRI) was carried out baseline and after the operation.
Depending on the presence of complications, patients were divided into groups, reflecting the outcomes:
Group 1 - patients with a favorable prognosis; Group 2 - patients with postoperative heart failure.
Results. According to our data predictive value for the occurrence of heart failure in the postoperative period
have increased size, the volume of the LV, LA, increased LV myocardial stress, decreased integral velocity
in the LV outflow tract, reduced systolic integral remodeling index, the average circular strain of the left
ventricle basal part, reduced longitudinal strain of the mitral valve fibrous ring, average longitudinal LA
strain, reduced left ventricular apex rotation, the average circular apex strain, the longitudinal right ventricular
displacement, the reduced longitudinal strain rate of the septal part mitral valve fibrous ring, the average
circular strain of the LV basal part, the presystolic LV strain.
In multivariate analysis the Cox regression model revealed the highest quality for prognosis of the heart failure,
consisting of LV anterior-posterior size by MRI, left ventricular shortening fraction, ratio E/A, left ventricular
mitral valve fibrous ring diameter in diastole, the LA average longitudinal strain and the ratio E/e by
tricuspid valve.
Conclusion. The indicators that have predictive value for the development of heart failure in the postoperative
period, reflect the universal process of remodeling with the development of diastolic, systolic dysfunction,
damage LV longitudinal, circular functions, left atrial longitudinal function and damage of the mitral
valve fibrous ring function.
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