Спекл-трекинг эхокардиография в оценке систоло-диастолической функции левого желудочка при ишемической болезни сердца с учетом особенностей строения миокарда

В обзоре представлены диагностические возможности спекл-трекинг эхокардиографии (speckle tracking echocardio graphy) для оценки систоло-диастолической функции левого желудочка при ишемической болезни сердца с учетом особенностей строения миокарда. Спиральное строение миокарда и взаимодействие разнонаправленных волокон левого желудочка усложняют задачу оценки регионарной и глобальной сократимости левого желудочка. Спекл-трекинг эхокардиография позволяет измерить деформацию миокарда в продольном, циркулярном и радиальном направлениях. Обсуждается клиническое использование метода при наиболее опасных формах ишемической болезни сердца: остром инфаркте миокарда и нестабильной стенокардии. Спекл-трекинг эхокардиография позволяет выявлять компенсаторное увеличение деформации интактного миокарда, а также ротации левого желудочка при нарушениях локальной сократимости. Измерение глобальных значений деформации, скручивания и раскручивания левого желудочка представляет прогностическую информацию у больных с острым инфарк том миокарда и нестабильной стенокардией. Несмотря на преимущества, существуют препятствия, затрудняющие использование данного метода в клинической практике. Основные из них - качество ультразвукового изображения и отсутствие общепринятых нормативных значений величин деформации.

спекл-трекинг эхокардиография, продольная деформация, циркулярная деформация, радиальная деформация, левый желудочек, ишемическая болезнь сердца

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