Objective: to compare liver stiffness cut-off values for assessing liver fibrosis using two-dimensional shear wave elastography with literature data on results obtained using equipment from the same vendor.

Material and methods: the study included 54 women and 48 men aged from 22 to 86 years (median – 56 years), who were underwent transient elastography (FibroScan, Echosens, France) and two-dimensional shear wave elastography (Aplio 500, Canon Medical Systems, Japan) during routine follow-up for various chronic liver diseases. A comparative analysis of the two-dimensional shear wave elastography results according to two stratification systems (METAVIR score system and Baveno VI consensus criteria) was carried out with a study used same vendor equipment. Transient elastography was used as the reference method in both studies.

Results: there was a strong direct correlation between liver stiffness measured by transient elastography and two-dimensional shear wave elastography (r = 0.790, P < 0.001). The cut-off values for liver fibrosis staging according to METAVIR score system and to Baveno VI consensus criteria in the studies used the single vendor equipment were comparable. Thus, the cut-off value for F4 stage of liver fibrosis was 10.3 kPa (own data) versus 10.5 kPa, the cut-off value for high probability of presence of compensated advanced chronic liver disease – 11.3 kPa (own data) versus 10.6 kPa.

Conclusions: two-dimensional shear wave elastography is highly informative for liver fibrosis assessment according to both systems (METAVIR score system and Baveno VI consensus criteria). The cut-off values obtained with the use of single vendor equipment are comparable.

The article presents a case of instrumental diagnosis of the left gastric vein aneurysm in a 57-year-old patient with portal hypertension (cirrhosis as an outcome of chronic viral hepatitis C with presence of gastro-esophageal varices grade 3). The left gastric vein aneurysm was detected by ultrasound and confirmed by contrast enhanced computed tomography.

Objective: to assess and compare the values of peak systolic velocity in the middle cerebral artery (PSV MCA) and cardiothoracic ratio (CTR) in groups of fetuses suffering from severe anemia with hydrops fetalis and severe anemia without hydrops.

Material and methods: pregnant women with no fetal congenital abnormalities were divided to the 3 groups. The group 1 (n = 13) consisted of women with singleton pregnancy with severe fetal anemia with hydrops. The group 2 (n = 12) consisted of women with singleton pregnancy with severe fetal anemia without signs of hydrops. Multiple intrauterine transfusions were performed in groups 1 and 2. Women with normal pregnancy and outcomes were included to the group 3 (n = 368) for assessing of normal CTR values in fetuses.

Results: there were no significant differences of PSV MCA values between groups 1 and 2 (P = 0.093). On the other hand, the significant differences of CTR values obtained between groups 1 and 2 (P = 0.035). The CTR values in group 1 were higher than in group 2.

Conclusion: CTR value can be considered as an indicator of condition severity in fetuses with severe anemia.

Objective: to obtain the early predictors and predictive model for adverse left ventricular remodeling in patients with ST-segment elevation myocardial infarction.

Material and methods: the study included 141 patients with primary ST-segment elevation myocardial infarction. A comprehensive clinical, laboratory, and instrumental examination was carried out on days 7–9 from the disease onset, and in 24 and 48 weeks of follow-up with full pharmacotherapy preservation.

Results: the follow-up was completed in 125 (88.7%) patients. They were divided into two groups according to the results of echocardiography: the group with adverse left ventricular remodeling (n = 63) (an increase of end-diastolic volume index >20% and (or) end-systolic volume index >15% in 24 week in comparison with days 7–9 examination) and the group of slowly progressive left ventricular remodeling (n = 62). The frequency of adverse outcomes (repeated myocardial infarction, unstable angina, hospitalization for heart failure decompensation, ventricular arrhythmias, cardiac surgery) during 48 weeks of follow-up was 30.2% (19 patients) in the group of adverse left ventricular remodeling and 4.8% (3 patients) in the group of slowly progressive left ventricular remodeling. The odds ratio for adverse outcome was 8.5 (95% confidence interval – 2.4–30.5) (P = 0.001). According to the results of univariate regression analysis, the risk factors for adverse left ventricular remodeling were: waist circumference, brain natriuretic peptide, end-systolic volume index, left ventricular ejection fraction, end-systolic left ventricular elastance, including normalized to body surface area, left ventricular–arterial coupling index, local systolic pressure in the common carotid arteries. The predictive model including a waist circumference, value of brain natriuretic peptide, and left ventricular–arterial coupling index was developed according to the results of multivariate analysis.

Conclusion: the developed predictive model for various types of left ventricular remodeling after ST-segment elevation myocardial infarction is useful for risk stratification.

Objective: to compare the values of longitudinal and circumferential strain, rotation, twist, and untwist of the left ventricle in patients with acute coronary syndrome depending on the quality of ultrasound images.

Material and methods: depending on the quality of ultrasound images in a short axis planes 320 patients with acute coronary syndrome (unstable angina, myocardial infarction) were divided into two groups. The 1st group consisted of 210 patients with good quality of ultrasound images of the heart (decrease of image clarity less than 4 segments at all levels), the 2nd group – 110 patients with excellent quality of ultrasound images of the heart (high image clarity of all segments). There were clear images of heart structures in apical planes in both groups in all cases. The image quality assessed with the use of the 16-segment model of the left ventricle. The modules of the obtained values of global, average and regional strain, rotation, twist, and untwist were compared.

Results: the body mass index in the 1st group of patients (good quality of image) was significantly higher. The frequency of disorders of left ventricle regional strain in the groups was comparable. The values of circumferential strain (global, average, and regional, except for the apical inferior segment) were significantly lower in the 1st group of patients. The values of global longitudinal strain, average longitudinal strain at the level of the mid segments, and regional longitudinal strain of the mid segments of the left ventricle (except for the mid inferoseptal) were significantly lower in the 1st group of patients. There were no significant differences of left ventricle rotation (except for basal in systole), twist and untwist, and their indices between the groups. As well as no significant differences were obtained for standard echocardiography parameters between the groups.

Conclusion: the values of circumferential strain (global, average, and regional, except for the apical inferior segment) and longitudinal strain (global, average at the level of the mid segments, and regional for all mid segments except for the mid inferoseptal) depends on quality of ultrasound image in our study. The values of rotation (except for basal left ventricle rotation in systole), left ventricle twist and untwist does not depend on ultrasound images quality (good versus excellent).