Objective: to study the possibility of a new echocardiographic technology for assessing the effectiveness of myocardial work in detecting cardiotoxicity in patients with breast cancer, depending on the level of blood pressure during anthracycline chemotherapy.Material and methods: 30 women with triple-negative breast cancer were enrolled, 13 of them (43.3%) had arterial hypertension (AH). All patients underwent standard transthoracic echocardiography with assessment of left ventricular systolic function. The STE method was used to estimate the LV global longitudinal strain (GLS) in a two-dimensional mode. The efficiency of myocardial work was also evaluated.Results. After chemotherapy in patients with breast cancer the LVEF remained within normal values. After chemotherapy in breast cancer patients revealed a statistically significant decrease in GLS and myocardial work parameters. Also it has been shown that myocardial work parameters seem to better reflect the LV mechanical dysfunction compared to the GLS, especially in patients with breast cancer and high blood pressure.Conclusion. The first results of the study showed that in breast cancer patients who had high blood pressure at the time of the study, myocardial work parameters better reflect of the LV mechanical dysfunction than the GLS parameter. A new method for evaluating the effectiveness of myocardial work requires further research and study in cancer patients undergoing chemotherapy and radiation therapy.

Aim. To develop a protocol for ultrasound diagnostics of COVID-19 pneumonia and to assess the diagnostic capabilities of the method in comparison with computer tomography (CT). Materials and methods. The study included 59 patients with a new coronavirus infection. In order to identify changes in the lung tissue characteristic of a new coronavirus infection, we used a special protocol for ultrasound of the lungs, which was developed by us in such a way that the data obtained were compared by segment with the results of CT of the lungs. Results. When comparing the results of lung ultrasound with the data of CT diagnostics, according to the new protocol, the percentage of lung tissue damage during ultrasound of the lungs averaged 70.8% in the group [62.5; 87.5], and according to the results of CT 70.0% [60.0; 72.5] (p=0.427). Thus, the ultrasound of the lung lesions was almost completely consistent with the changes revealed by CT. In order to assess the diagnostic value of lung ultrasound in identifying severe lung tissue lesions corresponding to CT 34, ROC analysis was performed, which showed the high diagnostic value of lung ultrasound in identifying severe lung tissue lesions. Conclusion. A new protocol was developed for assessing the severity of lung tissue damage according to ultrasound data, which showed a high diagnostic value in detecting COVID-19 pneumonia in comparison with CT. The results obtained give reason to recommend this protocol of ultrasound of the lungs as a highly sensitive method in diagnosing the severity of COVID-19 pneumonia. Its application is very important for dynamic examination of patients, especially in conditions of low availability of CT.

The aim of the study was to study the effect of combined chemotherapy in women with breast cancer (BC) on arterial stiffness and pulse wave by ultrasound examination of the common carotid artery (CCA) using echo tracking technology.Materials and methods. 40 women with triple negative breast cancer aged 27 to 75 years (47.5±12.0) were examined initially and after chemotherapy with the inclusion of anthracyclines (doxorubicin), taxanes (paclitaxel) and platinum derivatives (cisplatin). Arterial stiffness parametres (β-stiffness index, Ep-elastic modulus, AC-arterial compliance, PWV-pulse wave velocity) and AI - augmentation index were studied in the distal CCA at a distance of 2 cm from bifurcation on an Aloka ProSound α7 ultrasound machine using echo tracking technology.Results. After combined chemotherapy the parameters b, Ep, PWV not significantly changed (9,3±4,3 vs 8,9±4,5, р=0,63 ;128,73±65,9 vs 119,0±69,5 кПа, р=0,29 ; 6,7±1,5 vs 6,3±1,5 m/s, р=0,24 respectively). Statistically significant decrease in AI from 14, 5±11.3 to 11.1±10.6% (p=0.009) and an increase in AC from 0.72±0.25 to 0.87±0.3 mm2 / kPa (p=0.004) were demonstrated as well as decrease in systolic blood pressure (SBP) from 129.5±14.0 to 118.5±14.5 mm Hg (p=0.0001) and an increase in heart rate from 67.9±10.7 to 76.6±12.1 bpm (p=0.0004), lower the level of hemoglobin from 129.6±20.4 to 102.2±16.3 g / l (p=0.00001) and red blood cells from 4.7±0.4 to 3.3±0.6 1012 / l (p=0.00001).Conclusion: In women with breast cancer in the early period after combined chemotherapy with the inclusion of anthracyclines (doxorubicin), taxanes (paclitaxel) and platinum derivatives (cisplatin), there were no increased stiffness of the common carotid artery. Pseudo-positive changes in the form of an increase in the extensibility of the vascular wall and a decrease in the augmentation index are explained by general hemodynamic changes in the form of a decrease in the SBP, an increase in heart rate, as well as anemia during chemotherapy.

Aim. To assess left atrial (LA) strain parameters in candidates for coronary artery bypass grafting (CABG) and to evaluate their possible relationship with newly diagnosed atrial fibrillation (AF) after isolated CABG.Material and methods. The study Included 70 patients without prior AF (mean age, 65±8 years; men, 80%). Preoperative speckle-tracking echocardiography with an assessment of LA strain was performed. Two following groups were considered: without postoperative AF (POAF) (n=50), with postoperative POAF (n=20). After surgery, daily electrocardiography (ECG), 3-day postoperative continuous ECG monitoring, Holter ECG monitoring on the 4th-5th day after CABG. The median follow-up was 9 (7; 11) days.Results. Postoperative AF developed in 20/70 (29%) patients. Clinical, demographic and intraoperative parameters of CABG in the groups without and with POAF were comparable. Echocardiographic parameters in the studied groups were also equivalent; LA volume (57,0±8,7 vs 60,0±12,1, respectively), LA size (3,9±0,3 vs 3,9±0,2, respectively). Strain analysis showed its significant decrease in the group with POAF compared to the group without POAF: peak atrial longitudinal strain (PALS) (20,4±3,1 vs 27,8±3,0, respectively), ALS early (8,50±1,5 vs 11,8±1,7, respectively), ALS late (-0,2±0,7 vs -1,0±1,0). ROC analysis established the predictive value of PALS as follows: a value of ≤23,0% with a sensitivity of 90% and a specificity of 78% was a predictor of postoperative AF.Conclusion. Conventional echocardiographic predictors (LA size and volume) indicating a high risk of POAF cannot correctly assess the risk of newly diagnosed postoperative arrhythmia. AF after CABG is probably associated with the existing subclinical LA dysfunction as a result of structural abnormalities due to coronary artery disease. Our study showed that a decrease in LA strain parameters is associated with POAF. Further studies are needed to evaluate the contribution of speckle-tracking echocardiography to prediction of POAF.

Aim.To study the possibilities of speckle-tracking echocardiography (STE) in 3D mode in assessing the strain of the myocardium and identifying subclinical cardiotoxicity during anthracycline-containing chemotherapy in breast cancer patients with arterial hypertension. Materials and methods.The study included 47 patients with triple negative breast cancer (BC) with AH and normotension. All patients underwent transthoracic echocardiography with an assessment of the left ventricular (LV) ejection fraction, also used STE in three-dimensional mode with an assessment of global longitudinal (GLS), circular (GCS), radial (GRS) strain and a new strain parameter strain area (GAS). Results.In patients with BC for a more accurate assessment of LV systolic function, it is advisable to use 3D echocardiography. In BC patients with AH, the initial parameters of LV strain were statistically significantly worse than in patients with normotension and further deterioration was observed after chemotherapy. To determine the sensitivity and specificity of the strain parameters from the 3D-STE data, an ROC analysis was performed. The most diagnostically significant parameter of strain, as a marker of cardiotoxicity, was the global area strain (GAS), which with a cut-off value -14.0% showed a sensitivity equal to 81.5% and a specificity of 73.3%, but the value this parameter of LV deformation requires further study. Conclusion.In BC patients with AH and normotension it is advisable to use the STE in 3D mode to analyze the strain and systolic function of the LV during antitumor treatment. The method is promising for identifying subclinical cardiotoxicity, but further research is needed to develop diagnostic criteria.