The aim of the study was to assess the impact of surgical revascularization on left ventricular function using standard echocardiographic study and Velocity Vector Imaging technology. Materials and methods. 40 patients with ischemic heart disease were examined before and 12 days, 6, 12 and 24 months after coronary artery bypass grafting (CABG). A standard echocardiographic (EchoCG) study was performed on ultrasound scanner Acuson Х 300 (Siemens, USA) with a 5–1 MHz sector multifrequency sensor. For objective assessment of myocardial function, the analysis of left ventricular (LV) deformation and rotational properties was performed using Syngo VVI (Siemens Medical Solutions USA Inc., США) in 720 LV segments. Results. Standard EchoCG showed a stable systolic, diastolic and contractile LV function during 2 years of follow-up. The study of global values of strain (S) and strain rate (SR) showed a decrease in longitudinal S 6 months after CABG in the right coronary artery (RCA) area in the group of patients with complaints compared to those who had no complaints (p = 0.004), in addition, in this zone there was a tendency to a difference in longitudinal SR between these two groups (p = 0.07). In anterior descending artery area was a tendency to decreased strain of longitudinal fibers (p = 0.06) during the same period of observation. 1 year after CABG, strain decreased in patients with complaints (p = 0.04) in the circumference artery area only in circular fibers. Positive dynamics were noted in the diastolic function of left ventricular fibers and rotation indices. Conclusion. The use of Velocity Vector Imaging after coronary bypass surgery shows a change in the function of myocardial fibers in the areas of coronary arteries, which is important in patients complaining of angina pain.
Введение. Ишемическая болезнь сердца (ИБС) продолжает оставаться основной причиной летальности, несмотря на успехи развития интервенционной кардиологии и методов лечения острого коронарного синдрома [1]. Одним из основных направлений медицины является выявление и лечение острых форм ИБС -нестабильной стенокардии и инфаркта миокарда (ИМ) с помощью интервенционной хирургии. Однако бывают ситуации, когда экстренную реваскуляризацию выполнить невозможно. Это связано с поздним обращением за медицинской помощью, задержкой госпитализации, недоступностью ЛУЧЕВАЯ ДИАГНОСТИКА И ТЕРАПИЯ № 4 (7) 2016
A dynamic follow-up of 79 pregnant patients with insulin-dependent diabetes mellitus was carried out. Specific fetoplacental hormonal profiles were detected and analyzed in complex with glycemic levels, this permitting the authors obtain new prognostic criteria of fetal and newborn viability. The results helped optimize the policy of following up such patients and the developed prediction regulations allowed preventive measures aimed at improvement of the future baby health status to be carried out before clinical manifestation of fetal intrauterine suffering.
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