cardioКардиологияKardiologiia0022-90402412-5660Kardiomag10.18087/cardio.2025.5.n2915cardio-2915Research ArticleОБЗОРЫREVIEWSЭхокардиографическая диагностика легочной гипертензии: от простого к сложномуEchocardiography in the Diagnosis of Pulmonary Hypertension: From Basic to Advancedhttps://orcid.org/0000-0002-6168-8895МалевЭ. Г.MalevE. G.

ведущий научный сотрудник НИО некоронарогенных заболеваний сердца

Leading Researcher of the Non-Coronarogenic Heart Diseases Research Institute

edwardmalev@hotmail.comhttps://orcid.org/0000-0003-4896-1516МаликовК. Н.MalikovK. N.

врач функциональной диагностики

Functional Diagnostics Physician

knighterrantw@gmail.comhttps://orcid.org/0000-0001-6954-7096ГончароваН. С.GoncharovaN. S.

старший научный сотрудник НИЛ кардиомиопатий

Senior Researcher of the Cardiomyopathy Research Institute

ns.goncharova@gmail.comhttps://orcid.org/0000-0001-9478-1941СимаковаМ. А.SimakovaM. A.

старший научный сотрудник НИЛ кардиомиопатий

Senior Researcher of the Cardiomyopathy Research Institute

simakova_ma@almazovcentre.ruhttps://orcid.org/0000-0002-3655-9709КарелкинаЕ. В.KarelkinaE. V.

научный сотрудник НИЛ кардиомиопатий

Research Associate of the Cardiomyopathy Research Institute

ekarelkina@mail.ruРябковВ. А.RyabkovV. A.https://orcid.org/0000-0002-7817-3847МоисееваО. М.MoiseevaO. M.

профессор, главный научный сотрудник НИО некоронарогенных заболеваний сердца, директор Института сердца и сосудов

Chief Researcher of the Non-Coronarogenic Heart Diseases Research Institute

moiseeva.cardio@gmail.comФГБУ «Национальный медицинский исследовательский центр им. В. А. Алмазова» Минздрава России, Санкт-Петербург; ФГБОУ ВО «Петрозаводский государственный университет», ПетрозаводскРоссияAlmazov National Medical Research Center, Saint Petersburg; Petrozavodsk State University, PetrozavodskRussian FederationФГБОУ ВО «Петрозаводский государственный университет», ПетрозаводскРоссияPetrozavodsk State University, PetrozavodskRussian Federation2025020620256555869Copyright © Kardiomag, 20252025KardiomagKardiomaghttps://cardio.elpub.ru/jour/about/submissions#copyrightNoticehttps://cardio.elpub.ru/jour/article/view/2915

Клинические симптомы легочной гипертензии (ЛГ) неспецифичны и обусловлены как высоким давлением в системе легочной артерии, так и прогрессирующей недостаточностью правого желудочка. Инструментальная диагностика легочной артериальной гипертензии (ЛАГ) и хронической тромбоэмболической легочной гипертензии (ХТЭЛГ) сложна и требует использования в диагностическом алгоритме инвазивных и неинвазивных визуализирующих методов, важную роль среди которых играет эхокардиография (ЭхоКГ). При первичном (скрининговом) обследовании ЭхоКГ позволяет оценить вероятность наличия ЛГ, структуру и функцию правых и левых камер сердца, оценить возможные причины повышенного давления в легочной артерии. Эхокардиографическая визуализация постоянно развивается, и измерения, сделанные с использованием новых методов, таких как деформация миокарда, 3D-визуализация, позволяют получить больше информации о правых камерах сердца в экспертном центре, специализирующемся на ведении пациентов с ЛАГ и ХТЭЛГ. Настоящий обзор направлен на описание параметров и их прогностического значения, используемых для диагностики ЛГ при первичной (скрининговой) ЭхоКГ, так и при обследовании в экспертном центре. Эхокардиографическое обследование пациентов с ЛАГ и ХТЭЛГ представлено согласно этапам их маршрутизации. Представлены расширенные эхокардиографические протоколы первичного (скринингового) обследования и обследования в экспертном центре.

Clinical symptoms of pulmonary hypertension (PH) are non-specific and are caused by both high pressure in the pulmonary artery system and progressive right ventricular failure. Instrumental diagnosis of pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) is complex and requires using invasive and non-invasive imaging methods in the diagnostic algorithm, among which echocardiography (EchoCG) plays an important role. In the initial (screening) evaluation, EchoCG allows assessing the probability of the presence of pulmonary hypertension, the structure and function of the right and left heart chambers, and possible causes of increased pulmonary artery pressure. Echocardiographic imaging is continuously evolving, and measurements made with new methods, such as myocardial strain and 3D imaging, provide access to more information about the right heart chambers in an expert center for the management of patients with PAH and CTEPH. This review describes the parameters and their prognostic value for the diagnosis of PH during both primary (screening) EchoCG and examination in an expert center. Echocardiographic examination of patients with PAH and CTEPH is presented according to their routing stages. Extended EchoCG protocols for primary (screening) examination and examination in an expert center are presented.

 

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