The diagnostic value of three-dimensional echocardiography and speckle tracking echocardiography in patients after myocardial infarction with right ventricle involvement (clinical case)

Abstract

Диагностическая ценность трехмерной эхокардиографии и спекл-трекинг эхокардиографии у пациентов после инфаркта миокарда с вовлечением правого желудочка (клинический случай) М. Ю. Колесник Инфаркты миокарда (ИМ) нижней стенки левого желудочка (ЛЖ) часто осложняются поражением правого желудочка (ПЖ). Стандартным эхокардиографическим показателям не хватает диагностической точности в оценке функции ПЖ. Спекл-трекинг эхокардиография и трехмерная эхокардиография -перспективные диагностические инструменты количественной оценки состояния ПЖ.Цель работы -представить роль спекл-трекинг эхокардиографии и трехмерной эхокардиографии у больных после ИМ нижней стенки с вовлечением ПЖ.The inferior myocardial infarctions (MI) of left ventricle (LV) are often complicated with right ventricle (RV) involvement. The traditional echocardiographic parameters lack diagnostic accuracy in assessment of RV function. Speckle tracking echocardiography and three-dimensional echocardiography are promising diagnostic tools in quantification of RV.The purpose of the study was to present the role of speckle tracking echocardiography and three-dimensional echocardiography in patients after inferior MI with RV involvement.It was described a clinical case of a 67-year old male after recent inferior MI with RV involvement. The speckle tracking analysis and three-dimensional echocardiography was performed one and six months after coronary event. The initial study revealed decreased longitudinal strain of RV free wall segments, especially in the apical region. The RV global longitudinal strain was -8,8 % (normal range ≤ -20 %). The RV end-diastolic volume index was 100.9 ml/m 2 (normal range <87 ml/m 2 ) and RV end-systolic volume index was 69.8 ml/m 2 (normal range <44 ml/m 2 ), indicating its severe enlargement. The three-dimensional RV ejection fraction (EF) was 31 % (normal range >45 %).The analysis on the sixth month revealed improvement of RV contractility in all segments with global longitudinal strain of -14.2 %. The RV volumes decreased by 10 % and EF was raised from 31 to 33 %, reflecting positive cardiac remodeling during follow-up period. Conclusions.Speckle tracking echocardiography and three-dimensional echocardiography provide additional diagnostic information in patients after MI with RV involvement and can be used for patients' follow-up.