Clinical Physiology of Circulation

ISSN 1814-6910 (Print)
ISSN 2410-9134 (Online)

 

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Issue's catalogue ➤ КФК. 2018; 15 (4): 237-299 ➤ Изменения деформации миокарда левого желудочка у больных ишемической болезнью сердца при стресс-эхокардиографии

Changes in myocardial deformation of the left ventricle in patientswith ischemic heart disease under stress echocardiography

Authors: S.D. Pirtskhalava, E.U. Asymbekova, N.K. Akhmedyarova, A.Z. Rakhimov, V.Yu. Buziashvili, E.F. Tugeeva, S.T. Matskeplishvili, Yu.I. Buziashvili

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2018-15-4-249-260

UDC: 616.124.2-007.24:616.12-005.4]-073.43

Link: Clinical Physiology of Blood Circulaiton. 2018; 15 (4): 249-260

Quote as: Pirtskhalava S.D., Asymbekova E.U., Akhmedyarova N.K., Rakhimov A.Z., Buziashvili V.Yu., Tugeeva E.F., Matskeplishvili S.T., Buziashvili Yu.I. Changes in myocardial deformation of the left ventricle in patients with ischemic heart disease under stress echocardiography. Clinical Physiology of Circulation. 2018; 15 (4): 249–60 (in Russ.). DOI: 10.24022/1814-6910-2018-15-4-249-260

Keywords:  stress echocardiography echocardiography myocardial ischemia myocardial deformation left ventricle ischemic heart disease

Received / Accepted:  05.07.2018/12.08.2018

Download
Full text:  

Abstract

Objective. To determine the value of deformation of the myocardium (DM) as a diagnostic marker of myocardial ischemia in stress-echocardiography in patients with ischemic heart disease (IHD).

Material and methods. 51 people were examined, including 17 control groups, 34 – patients with IHD. All examined included stress echocardiography with the study of myocardial deformation by tissue dopplerography. The reference method is coronaroangiography.

Results. According to the results of the survey, it was found that in healthy individuals the loading test is accompanied by an increase in deformation and strain rate. In patients with IHD at rest, DM is significantly lower than in the control group (p=0.0001), with stress echocardiography there is a decrease in DM and strain rate. The degree of change in the ejection fraction (EF) and the degree of change in the DM at a load relative to the initial level differ significantly. Changes in DM significantly exceeded the degree of decrease in EF (DM 24.5±14.3%, EF 9.07±13.9%; p =0.00004, 95% CI 8.7 – 22.09).

Conclusion. The study of myocardial deformation in stress echocardiography in addition to the traditional indices of systolic and diastolic function plays an important role in the diagnosis of IHD.

References

  1. Бузиашвили Ю.И., Гунджуа Ц.А., Асымбекова Э.У., Жожадзе Ш.Ш., Бурдули Т.В., Церетели Н.В., Мацкеплишвили С.Т. Продольная систолическая функция миокарда левого желудочка в покое и при нагрузке в норме. Клиническая физиология кровообращения. 2007; 1: 33–9. [Buziashvili Yu.I., Gundzhua Ts.A., Asymbekova E.U., Zhozhadze Sh.Sh., Burduli T.V., Tsereteli N.V., Matskeplishvili S.T. Longitudinal systolic function of the left ventricular myocardium at rest and under normal load. Clinical Physiology of Circulation. 2007; 1: 33–9 (in Russ.).]
  2. Асымбекова Э.У., Мацкеплишвили С.Т., Ахмедярова Н.К., Ушерзон М.Б., Харитонова Н.И., Амбатьелло С.Г. и др. Обратимая дисфункция миокарда левого желудочка при ИБС – особенности клинического течения. В кн: Пятый Всероссийский съезд сердечно-сосудистых хирургов. Тезисы докладов и сообщений. М.; 1999: 53. [Asymbekova E.U., Matskeplishvili S.T., Akhmedyarova N.K., Usherzon M.B., Kharitonova N.I., Ambat'ello S.G. et al. Reversible myocardial dysfunction of the left ventricle with IHD – features of the clinical course. In: The Fifth All-Russian Congress of Cardiovascular Surgeons. Abstracts and reports. Moscow; 1999: 53 (in Russ.).]
  3. Picano E., Ciampi Q., Citro R., D'Andrea A., Scali M.C., Cortigiani L. et al. Stress echo 2020: the international stress echo study in ischemic and nonischemic heart disease. J. Cardiovasc. Ultrasound. 2017; 15 (1): 1–21. DOI: 10.1186/s12947-016-0092-1
  4. Sicari R., Cortigiani L. The clinical use of stress echocardiography in ischemic heart disease. Cardiovasc. Ultrasound. 2017; 15 (1): 7. DOI: 10.1186/s12947-017-0099-2
  5. Stokke T.M., Hasselberg N.E., Smedsrud M.K., Sarvari S.I., Haugaa K.H., Smiseth O.A. et al. Geometry as a confounder when assessing ventricular systolic function: comparison between ejection fraction and strain. J. Am. Coll. Cardiol. 2017; 70 (8): 942–54. DOI: 10.1016/j.jacc.2017.06.046
  6. Longobardo L., Suma V., Jain R., Carerj S., Zito C., Zwicke D.L. et al. Role of two-dimensional speckletracking echocardiography strain in the assessment of right ventricular systolic function and comparison with conventional parameters. J. Am. Soc. Echocardiogr. 2017; 30 (10): 937–46. DOI: 10.1016/j.echo. 2017.06.016
  7. Васюк Ю.А. Руководство по функциональной диагностике в кардиологии. М.: Практическая медицина; 2012. [Vasyuk Yu.A. Manual on functional diagnostics in cardiology. Moscow: Prakticheskaya Meditsina; 2012 (in Russ.).]
  8. Yip G., Abraham T., Belohlavek M., Khandheria B.K. Clinical applications of strain rate imaging. J. Am. Soc. Echocardiogr. 2003; 16: 1334–42. DOI: 10.1067/j.echo.2003.09.004
  9. Бузиашвили Ю.И., Бурдули Т.В., Мацкеплишвили С.Т., Асымбекова Э.У., Шахназарян Л.С., Тугеева Э.Ф. и др. Применение метода тканевой миокардиальной допплер-эхокардиографии с добутамином для выявления обратимой ишемической дисфункции у больных с инфарктом миокарда. Сердечно-сосдистые заболевания. Бюллетень НЦССХ им. А.Н. Бакулева РАМН. 2009; 10 (1): 161–7. [Buziashvili Yu.I., Burduli T.V., Matskeplishvili S.T., Asymbekova E.U., Shakhnazaryan L.S., Tugeeva E.F. et al. Application of the method of tissue myocardial doppler echocardiography with dobutamine for detec- tion reversible ischemic dysfunction in patients with myocardial infarction. Bulletin of Bakoulev Center for Cardiovascular Diseases. 2009; 10 (1): 161–7 (in Russ.).]
  10. Voigt J.U., Flachskampf F.A. Strain and strain rate. New and clinically relevant echo parameters of regional myocardial function. J. Z. Kardiol. 2004; 93 (4): 249–58. DOI: 10.1007/s00392-004-0047-7
  11. Бузиашвили Ю.И., Асымбекова Э.У., Мацкеплишвили С.Т., Арипов М.А. Возможности тканевой допплер-эхокардиографии в оценке регионарной диастолической функции левого желудочка у больных ишемической болезнью сердца. Грудная и сердечно-сосудистая хирургия. 2002; 5: 28–32. [Buziashvili Yu.I., Asymbekova E.U., Matskeplishvili S.T., Aripov M.A. Possibilities of tissue Doppler echocardiography in assessing the regional diastolic function of the left ventricle in patients with coronary heart disease. Russian Journal of Thoracic and Cardiovascular Diseases. 2002; 5: 28–32 (in Russ.).]
  12. Бузиашвили Ю.И., Бурдули Т.В., Асымбекова Э.У., Мацкеплишвили С.Т., Шахназарян Л.С., Жожадзе Ш.Ш. Возможности практического применения тканевой миокардиальной допплер-эхокардиографии в оценке функционального состояния миокарда у больных ИБС. Сердечно-сосудистые заболевания. Бюллетень НЦССХ им. А.Н. Бакулева РАМН. 2006; 7 (прил. 5): 261. [Buziashvili Yu.I., Burduli T.V., Asymbekova E.U., Matskeplishvili S.T., Shakhnazaryan L.S., Zhozhadze Sh.Sh. Possibilities of practical use of tissue myocardial Doppler echocardiography in assessing the functional state of the myocardium in patients with IHD. Bulletin of Bakoulev Center for Cardiovascular Diseases. 2006; 7 (Suppl. 5): 261 (in Russ.).]
  13. Ng A.C., Thomas L., Leung D.Y. Tissue Doppler echocardiography. J. Minerva Cardioangiol. 2010; 58 (3): 357–78.
  14. Dattilo G., Imbalzano E., Lamari A., Casale M., Paunovic N., Busacca P., Di Bella G. Ischemic heart disease and early diagnosis. Study on the predictive value of 2D strain. Int. J. Cardiol. 2016; 215: 150–6. DOI: 10.1016/j.ijcard.2016.04.035
  15. Murai D., Yamada S., Hayashi T., Okada K., Nishino H., Nakabachi M. et al. Relationships of left ventricular strain and strain rate to wall stress and their afterload dependency. Heart Vessels. 2017; 32 (5): 574–83. DOI: 10.1007/s00380-016-0900-4
  16. Park J.J., Park J.B., Park J.H., Cho G.Y. Global longitudinal strain to predict mortality in patients with acute heart failure. J. Am. Coll. Cardiol. 2018; 71 (18): 1947–57. DOI: 10.1016/j.jacc.2018.02.064
  17. Cha M.J., Kim H.S., Kim S.H., Park J.H., Cho G.Y. Prognostic power of global 2D strain according to left ventricular ejection fraction in patients with ST elevation myocardial infarction. PLoS One. 2017; 12 (3): e0174160. DOI: 10.1371/journal.pone.0186437
  18. Aggeli C., Lagoudakou S., Felekos I., Panagopoulou V., Kastellanos S., Toutouzas K. et al. Two-dimensional speckle tracking for the assessment of coronary artery disease during dobutamine stress echo: clinical tool or merely research method. Cardiovasc Ultrasound. 2015; 13 (1): 43. DOI: 10.1186/s12947-015-0038-z
  19. Leitman M., Tyomkin V., Peleg E., Zyssman I., Rosenblatt S., Sucher E. et al. Speckle tracking imaging in normal stress echocardiography. J. Ultrasound. Med. 2017; 36 (4): 717–24. DOI: 10.7863/ultra.16.04010
  20. Radwan H., Hussein E. Value of global longitudinal strain by two dimensional speckle tracking echocardiography in predicting coronary artery disease severity. Egypt Heart J. 2017; 69 (2): 95–101. DOI:10.1016/j.ehj.2016.08.001
  21. Abohammar S., ElSaidy M.A., Fathalla D., Aldosarri M. Baseline characteristics of patients with heart failure and preserved ejection fraction at admission with acute heart failure in Saudi Arabia. Egypt Heart J. 2017; 69 (1): 21–8. DOI: 10.1016/j.ehj. 2016.08.002
  22. Medvedofsky D., Kebed K., Laffin L., Stone J., Addetia K., Lang R.M., Mor-Avi V. Reproducibility and experience dependence of echocardiographic indices of left ventricular function: side-by-side comparison of global longitudinal strain and ejection fraction. Echocardiography. 2017; 34 (3): 365–70. DOI:10.1111/echo.13446
  23. Wierzbowska-Drabik K., Trzos E., Kurpesa M., Rechcinski T., Miskowiec D., Cieslik-Guerra U. et al. Diabetes as an independent predictor of left ventricular longitudinal strain reduction at rest and during dobutamine stress test in patients with significant coronary artery disease. Eur. Heart J. Cardiovasc. Imaging. 2018; 19 (11): 1276–86. DOI: 10.1093/ehjci/jex315
  24. Voigt J.U., Exner B., Schmiedehausen K., Huchzermeyer C., Reulbach U., Nixdorff U. et al. Strain-rate imaging during dobutamine stress echocardiography provides objective evidence of inducible ischemia. J. Circulation. 2003; 107 (16): 2120–6. DOI: 10.1161/01.CIR.0000065249.69988.AA
  25. Norum I.B., Ruddox V., Edvardsen T., Otterstad J.E. Diagnostic accuracy of left ventricular longitudinal function by speckle tracking echocardiography to predict significant coronary artery stenosis. A systematic review. BMC Med. Imaging. 2015; 15 (1): 1–12. DOI:10.1186/s12880-015-0067-y

About Authors

  • Pirtskhalava Sofia Davidovna, Postgraduate; orcid.org/0000-0001-6305-5365
  • Asymbekova El'mira Umetovna, Dr. Med. Sc., Leading Researcher; orcid.org/0000-0002-5422-2069
  • Akhmedyarova Nazli Kerimovna, Cand. Med. Sc., Researcher; orcid.org/0000-0001-7157-6312
  • Rakhimov Akmal Zakriyaevich, Cand. Med. Sc., Researcher; orcid.org/0000-0002-9370-9419
  • Buziashvili Viktoriya Yur'evna, Cand. Med. Sc., Cardiologist
  • Tugeeva El'vina Faatovna, Dr. Med. Sc., Senior Researcher
  • Matskeplishvili Simon Teymurazovich, Dr. Med. Sc., Professor, Corresponding Member of the Russian Academy of Sciences
  • Buziashvili Yuriy Iosifovich, Dr. Med. Sc., Professor, Academician of the Russian Academy of Sciences, Head of Clinical and Diagnostic Department

 If you found mistakes, select text and press Alt+A