ABSTRACT
AIM: to study myocardial function in patients with chronic heart failure (CHF) with preserved left ventricular ejection fraction (PEF) by speckle tracking echocardiography and tissue doppler imaging. MATERIALS AND METHODS: We examined 80 patients aged 50-70 years with verified NYHA class I-IIa CHF and PEF due to arterial hypertension and ischemic heart disease, and 35 healthy persons. Examination included echocardiography, and speckle-tracking echocardiography. RESULTS: According to 6-min walk test 26.9 % of patients had functional class (FC) I CHF, 48.3 % - FC II CHF, and 24.8 - FC III CHF. The mean left ventricular ejection fraction (Simpson's method) was 62.3±5.35 %, mean end systolic left atrial volume index - 45±8.1 ml / m2. All patients had left ventricular diastolic dysfunction: 60 patients - abnormal relaxation pattern, 20 patients - pseudonormal pattern. Other findings were reduced global longitudinal strain (GLS, -16.56±2.61 %) and GLS rate (GLSR, -0.75±0.11 s-1) of the left ventricle and reduced segmental strain and strain rate in basal anteroseptal (-13.62±3.44 % and -0.77±0.04 s-1, respectively) and basal anterolateral (-14.17±3.31 % and -0.81±0.11 s-1, respectively) segments. Lowering of global circular left ventricular strain and strain rate (-15.63±4.8% and -1.4±0.23 s-1, respectively) was found to be smaller than that of GLS (p<0.05). There was positive correlation between left ventricular systolic GLS and left atrial volume (r=0.601, Ñ<0.01). CONCLUSIONS: In patients with CHF and PEF we revealed alterations of diastolic function (abnormal relaxation and pseudonormal patterns), reductions of global and segmental strain and strain rate of the left ventricle. More pronounced lowering of segmental strain and strain rate was registered in left ventricular basal anteroseptal and basal anterolateral segments. Circular strain was found to be slightly reduced, while radial strain was unchanged.
Subject(s)
Heart Failure , Ventricular Dysfunction, Left , Aged , Echocardiography , Heart Failure/diagnostic imaging , Humans , Middle Aged , Myocardium , Stroke Volume , Ventricular Function, LeftSubject(s)
Adrenergic beta-Antagonists/therapeutic use , Antihypertensive Agents/therapeutic use , Hypertension/complications , Hypertension/drug therapy , Pulmonary Disease, Chronic Obstructive/complications , Pulmonary Disease, Chronic Obstructive/drug therapy , Adolescent , Adrenergic beta-Antagonists/administration & dosage , Adrenergic beta-Antagonists/adverse effects , Adult , Age Factors , Aged , Aged, 80 and over , Antihypertensive Agents/administration & dosage , Antihypertensive Agents/adverse effects , Contraindications , Female , Humans , Hypertension/classification , Male , Meta-Analysis as Topic , Middle Aged , Myocardial Infarction/drug therapy , Placebos , Randomized Controlled Trials as Topic , Time FactorsABSTRACT
The possibility of electrocardiographic diagnosis of infarction of the right ventricle is discussed. Twenty-four cases of right-ventricular myocardial infarction are cited which were diagnosed on the basis of electrocardiographic signs. In 9 cases infarction of the right ventricle was confirmed during autopsy. It is recommended that the ECG in patients with infarction of the myocardium of the posterior wall of the left ventricle is recorded in additional leads, V3R and V4R. The presence of signs of infarction on such ECGs in the absence of such signs in V1-2 leads indicates that the infarction of the posterior wall of the left ventricle has extended to the right ventricle.
