Цель. Поиск возможных дополнительных дифференциально-диагностических критериев у пациенток с синдромом дилатационной кардиомиопатии (СДКМП) на основе оценки результатов деформации миокарда (ДМ) в режиме монито-ринга. Материал и методы. Обследовано 28 беременных с СДКМП, из них 10 -в возрасте 29±5,8 лет с постмиокардитическим кардиосклерозом и СДКМП, и 18 -без указаний на перенесенный миокардит и СДКМП в анамнезе. Группу конт роля составили 30 беременных пациенток с нормальной систолической и насосной функцией сердца и не измененной геометрией левого желудочка (ЛЖ). Всем пациенткам проводился суточный мониторинг ЭКГ и артериаль-ного давления. УЗИ сердца выполнялись по общепринятому протоколу в B-режиме, режимах импульсного и постоянного допплера, цветового доп-плеровского картирования с оценкой размеров полостей, внутрисердечной гемодинамики, давления в стволе легочной артерии и продольной, радиаль-ной, циркулярной глобальной систолической ДМ и скорости смещения соот-ветствующих волокон миокарда ЛЖ. Результаты. У беременных 1-й и 2-й гр. отмечены достоверные нарушения показателей силы и скорости миокарда наряду с негативным ремоделирова-нием полости ЛЖ по сравнению с гр. контроля. При сравнении между собой показателей 1-й и 2-й гр. было выявлено достоверное снижение продольной и циркулярной глобальной систолической ДМ у пациенток 1 гр. Заключение. Кроме оценки анатомии, внутрисердечной гемодинамики, систолической и насосной функции сердца у беременных с СДКМП целесо-образно использовать дополнительные диагностические критерии в виде показателей продольной, радиальной, циркулярной глобальной систоличе-ской ДМ. Aim. The search for plausible additional criteria of diagnosis in patients with the syndrome of dilation cardiomyopathy (SDCMP) on the basement of deformity of myocardium (MD) assessment results in life mode. Material and methods. Totally, 28 pregnant with SDCMP studied, of those 10 at the age 29±5,8 y. with postmyocarditis cardiosclerosis and SDCMP, and 18 -without anamnestic data of myocarditis or SDCMP. Controls consisted of 30 pregnant women with normal systolic and pumping heart function, and non-changed geometry of the left ventricle (LV). All patients underwent 24-hour ECG and blood pressure monitoring. USE of the heart was done by the common protocol in B-regimen, impulse and continuous Doppler, color Doppler with chambers size measurement, intracardiac hemodynamics, pressure in pulmonary artery stem, and longitudinal, radial and circular global systolic MD and velocity of the shift of respective LV myocardial fibers.Results. In the pregnant of 1st and 2nd groups there were significant disorders of the force and velocity of myocardium, together with negative remodeling of LV chamber, comparing to the controls. While comparing the parameters of 1 and 2 groups, there was significant decrease of longitudinal and circular global systolic MD in patients of the 1 group. Conclusion. Except the assessment of anatomy, intracardiac hemodynamics, systolic and pumping function of the heart of the pregnant with ...

Non-compaction of the ventricular myocardium (NCM) is a genetic cardiomyopathy usually due to mutationof the G4.5 gene located in the Xq28 chromosomal region. This congenital disorder is characterized by pronounced trabeculations and intertrabecular recesses resulting from abnormal embryogenesis between the fifth and eighth fetal weeks. The reported prevalence in the general population is between 0.014% and 1.3%. The classic triad of complications includes heart failure, ventricular arrhythmias and systemic embolic events, although some patients have an asymptomatic form. NCM is commonly diagnosed by echocardiography, but contrast ventriculography, CT and MRI can also be used. Here we present a case of left ventricle NCM, manifested after respiratory infection, in a pregnant patient with congenital thrombophilia and a history of myocardial infarction. LEARNING POINTS• Non-compaction myocardium (NCM) in pregnant women has been associated with a poor prognosis.• We should avoid routinely recommending young women with NCM to refuse pregnancy.• A decision to continue pregnancy should be made by the patient in discussion with specialists. KEYWORDS Non-compaction myocardium, pregnancy, heart failure, thrombophilia. CASE REPORTA 26-year-old female patient was admitted to hospital in 2014 with complaints of dyspnoea. The patient had a family history of sudden death (her father), but she herself had shown no signs of cardiovascular disease until 2009. Pregnancies in 2007 and 2008 had ended in miscarriage at 6-8 weeks. Antiphospholipid syndrome was excluded. In 2009, signs of heart failure (shortness of breath, oedema of the legs) and episodes of unsustainable ventricular tachycardia (VT) manifested after respiratory infection and were associated with a reduction in ejection fraction (EF) to 26%. In 2010 the patient had a myocardial infarction of the LV inferior wall and right ventricle (RV), complicated by thrombus formation in the RV. Intact coronary arteries were found on angiography. Embolic genesis of the myocardial infarction was suspected. Genetic testing revealed hereditary thrombophilia with increased sensitivity to warfarin. Echocardiography and MRI were performed and non-compaction myocardium of the LV was observed (Figs. 1 and 2). Following therapy with ACE inhibitors, beta-blockers,

The actuality. The acute disorders of cerebral blood circulation of ischemic type is a rare but dangerous complication of pregnancy. The etiology of ischemic disorders is different. The rate of strokes increases during pregnancy. The pre-eclampsia and eclampsia can become a cause of ischemic stroke.The purpose of study. To analyze structure, etiology, rate of ischemic disorders of cerebral blood circulation in pregnant women, women in labor and puerperia for optimization of tactics of obstetrics care support.The materials and methods. The analysis of 76 cases of acute disorder of cerebral blood circulation of ischemic type in anamnesis and during gestation. The conclusions. The rate of ischemic disorders of cerebral blood circulation is reliably higher in pregnant women as compared with women of reproductive age without pregnancy. The pre-eclampsia and eclampsia became a cause of development of ischemic stroke in 18.3% of cases.