Особенности эхокардиографического исследования у больных с COVID – 19

Новая коронавирусная инфекция стала одной из актуальных проблем здравоохранения ХХI века. Возникающие при этом расстройства часто приводят к формированию кардиопульмональной патологии, требующей создания новой парадигмы в диагностике и лечении. Исследования, проведенные в период пандемии, показали важную роль эхокардиографии (ЭхоКГ) в диагностике дисфункции правого желудочка (ПЖ) у пациентов с дыхательной недостаточностью при COVID-19. С этой целью проведен анализ показателей ЭхоКГ, обладающих высокой прогностической ценностью. На основании полученных данных можно полагать, что при ЭхоКГ дополнительный акцент должен быть сделан на изучении размеров правых отделов сердца, сократительной функции ПЖ и систолического давления в легочной артерии (ЛА) как наиболее чувствительных показателей постнагрузки ПЖ и косвенных маркеров тяжести заболевания легких. Для оценки систолической функции ПЖ можно рекомендовать RV FAC как наиболее информативный показатель. Кроме того, установлено, что продольный стрейн ПЖ имеет дополнительное значение в ранней идентификации признаков систолической дисфункции и стратификации риска у пациентов с COVID-19. Помимо эффективности и воспроизводимости метода, важным преимуществом ЭхоКГ является ее доступность, возможность сохранять изображения для дистанционной интерпретации другими специалистами, отслеживание изменений морфофункциональных параметров сердца. Таким образом, проведенный анализ мировой литературы позволяет полагать, что ЭхоКГ играет важную роль в прогнозировании тяжелых кардиопульмональных нарушений, своевременном выборе стратегии лечения пациентов с COVID-19, поэтому должна служить дополнительным методом клинической оценки, особенно у лиц с умеренной или тяжелой формой заболевания.

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