The review discusses the prognostic value and contribution to therapy optimization of lung ultrasound for heart failure patients.

Ключевые слова: правый желудочек, правожелудочково-артериальное сопряжение, хроническая сердечная недостаточность, эхокардиография.Ссылка для цитирования: Исламова М. Р., Лазарев П. В., Сафарова А. Ф., Кобалава Ж. Д. Значение дисфункции правого желудочка, правожелудочково-артериального сопряжения при хронической сердечной недостаточности: роль эхокардиографии. Кардиология. 2018;58(5):82-90.Резюме В обзоре рассматриваются клиническое и прогностическое значение эхокардиографических методов оценки функции правого желудочка и правожелудочково-артериального сопряжения, преимущества и недостатки эхокардиографии в сравнении с другими инструментальными исследованиями у пациентов с хронической сердечной недостаточностью. SummaryIn this review article we discuss the clinical and prognostic value of echocardiographic evaluation methods of the right ventricular function and right ventricular -pulmonary artery coupling, advantages and disadvantages of echocardiography in comparison with other instrumental methods of investigation in patients with chronic heart failure. 54. Mehra M. R. Fat, Cachexia, and the Right Ventricle in Heart Failure. Journal of the American College of Cardiology 2013;62:1671.55. Voelkel N. F., Bogaard H. J., Gomez-Arroyo J. The need to recognize the pulmonary circulation and the right ventricle as an integrated functional unit: facts and hypotheses (2013 Grover Conference series). Pulmonary circulation 2015;5:81-89.

Aim      To determine the incidence rate and the practical significance of right ventricular dysfunction (RVD) in the development of cardiovascular complications in patients with decompensated chronic heart failure (DCHF).Material and methods  This prospective, single-site observational study included 171 patients older than 18 years with NYHA functional class (FC) II-IV chronic heart failure (CHF) who were hospitalized for DCHF. Standard and extended 2D and 3D echocardiography (EchoCG) was performed for all patients on admission. Additionally, functional characteristics of the right ventricle (RV) were evaluated in the 3D mode followed by autonomic 3D processing with a EchoPac station (USA). RVD was taken as a disorder of two or more RV functional parameters according to results of 2D EchoCG, or a reduced RV free wall strain according to results of 2D speckle-tracking EchoCG, or a reduced RV ejection fraction (EF) according to results of 3D EchoCG. Statistical analysis was performed with a SPSS Statistics v. 26.0 software.Results The incidence rate of RVD in general population of patients with DCHF was 75.4 % (n=129). A higher prevalence of RVD was observed in patients with CHF with a low left ventricular (LV) EF (90.1 %). Patients with RVD had a more severe clinical status (significantly higher FC and higher Clinical Condition Scale (CCS) scores), more frequent atrial fibrillation (AF), and higher concentrations of uric acid and total bilirubin. RVD significantly correlated with male sex (odds ratio (OR), 2.05; 95 % confidence interval (CI), 1.01–4.19; р=0.046) and AF (OR, 3.52; 95 % CI, 1.71–7.26; р<0.001). Patients with RVD had lower values of both LV and RV function. Lower LV EF and AF increased the probability of RVD by 1.06 times (95 % CI, 0.90–0.98; р=0.001) and by 2.63 times (95 % CI, 1.08–6.40; р=0.001), respectively. Evaluation of the predictive significance of RV parameters measured by 2D and 3D EchoCG showed only effects of RV EF (2D) and RV global longitudinal strain (GLS) (3D) on all-cause hospitalization. RVD as evaluated by accepted criteria did not influence adverse outcomes.Conclusion      The determined incidence, correlations, and the predictive value of RVD in patients with DCHF indicated the appropriateness of assessing the RV function to optimize the management of patients regardless of the CHF phenotype.