cardioКардиологияKardiologiia0022-90402412-5660Kardiomag10.18087/cardio.2022.6.n1805cardio-1805Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИRESEARCH ARTICLESЭффективность нагрузочной пробы Вальсальвы и спектральной следящей эхокардиографии в диагностике сердечной недостаточности с сохраненной фракцией выброса левого желудочкаThe Valsalva load test and spectral tracking echocardiography effectiveness in the diagnosis of heart failure with preserved left ventricular ejection fractionhttps://orcid.org/0000-0003-4239-9550СережинаЕ. К.SerezhinaE. K.

врач-кардиолог , аспирант кафедры госпитальной терапии СПбГУ

Cardiologist «International Medical Centre «SOGAZ» Limited liability company; PHD Saint-Petersburg State University

zlotnikova.elena.konst@gmail.comhttps://orcid.org/0000-0001-6115-7923ОбрезанА. Г.ObrezanA. G.

Профессор, д.м.н.,

Главный врач Международного Медицинского Центра "СОГАЗ"; Заведующий кафедрой госпитальной терапии СПбГУ. Общество с ограниченной ответственностью «Международный медицинский центр «СОГАЗ»

Professor, Saint-Petersburg State University; Chef doctor, «International Medical Centre «SOGAZ» Limited liability

zlotnikova.elena.konst@gmail.comООО "Международный медицинский центр "СОГАЗ", Санкт-Петербург, РоссияРоссияOOO International Medical Center “SOGAZ”, St. PetersburgRussian Federation2022300620226263036Copyright © Kardiomag, 20222022KardiomagKardiomaghttps://cardio.elpub.ru/jour/about/submissions#copyrightNoticehttps://cardio.elpub.ru/jour/article/view/1805

Цель    Определение применимости спектральной следящей ЭхоКГ и пробы Вальсальвы для диагностики сердечной недостаточности с сохраненной фракцией выброса левого желудочка (СНсФВ).

Материал и методы  Пациентам с СНсФВ и обследуемым здоровым лицам, сопоставимым с исследуемой группой по полу и возрасту и составляющим группу контроля, выполнялась трансторакальная спектральная следящая ЭхоКГ (STE) с одновременной регистрацией электрокардиограммы (ЭКГ) в покое и при выполнении пробы Вальсальвы. Исследование выполнено в соответствии со стандартами надлежащей клинической практики (Good Clinical Practice) и принципами Хельсинкской декларации. Протокол исследования одобрен этическим комитетом СПбГУ.

Результаты   При измерениях, проводимых при пробе Вальсальвы, отклонения показателей как общей, так и посегментной деформации миокарда оказались более очевидными, чем в покое. Отмечено увеличение таких показателей, как конечный диастолический объем ЛЖ и конечный систолический объем ЛЖ (99 %) при проведении пробы Вальсальвы у пациентов исследуемой группы. Выявлено существенное снижение частоты сердечных сокращений (достоверность различия превышает 99 %) при выполнении пробы Вальсальвы у пациентов с СНсФВ по сравнению с группой контроля. Повышение прогностической значимости данных параметров во время их оценки при выполнении данного маневра может служить основанием для включения указанного метода исследования в раннюю диагностику и прогностическую оценку СНсФВ.

Заключение     Спектральная следящая ЭхоКГ с выполнением пробы Вальсальвы является неинвазивным, широкодоступным и легко воспроизводимым в амбулаторных условиях методом диагностики СНсФВ.

 

Aim      To determine the applicability of speckle-tracking EchoCG (STE) and the Valsalva maneuver for diagnosis of heart failure with preserved left ventricular ejection fraction (CHFpEF).

Material and methods  Transthoracic STE with simultaneous electrocardiogram (ECG) recording was performed for patients with CHFpEF and healthy sex- and age-matched subjects (control group) at rest and during the Valsalva maneuver. The study was conducted in compliance with standards of Good Clinical Practice and principles of the Helsinki Declaration. The study protocol was approved by the Ethical Committee of the St. Petersburg State University.

Results During the Valsalva maneuver, deviations of both global and segmental myocardial strain were more pronounced than at rest. In patients of the study group performing the Valsalva maneuver, LV end-diastolic volume and LV end-systolic volume (99 %) were increased. Heart rate was considerably reduced (significance of difference >99%) in patients with CHFpEF during the Valsalva maneuver compared to the control group. The increased predictive value of these parameters during the Valsalva maneuver can justify the inclusion of this method in early detection and prognostic assessment of CHFpEF.

Conclusion      Speckle-tracking EchoCG with the Valsalva maneuver is a noninvasive, generally available, and easily reproducible outpatient method for diagnosis of CHFpEF.

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The authors declare that there are no conflicts of interest present.