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  • 99 -6 (80) 2025 - Bekmetova F.M., Fozilov X.G. - SPECKLE-TRACKING ECHOCARDIOGRAPHY IN THE ASSESSMENT OF STAGE-BY-STAGE CARDIAC REMODELING IN ISCHEMIC HEART FAILURE

99 -6 (80) 2025 - Bekmetova F.M., Fozilov X.G. - SPECKLE-TRACKING ECHOCARDIOGRAPHY IN THE ASSESSMENT OF STAGE-BY-STAGE CARDIAC REMODELING IN ISCHEMIC HEART FAILURE

SPECKLE-TRACKING ECHOCARDIOGRAPHY IN THE ASSESSMENT OF STAGE-BY-STAGE CARDIAC REMODELING IN ISCHEMIC HEART FAILURE

Bekmetova F.M. - Republican Specialized Scientific and Practical Medical Center of Cardiology Uzbekistan

Fozilov X.G. - Republican Specialized Scientific and Practical Medical Center of Cardiology Uzbekistan

Bekbulatova R.Sh. - Republican Specialized Scientific and Practical Medical Center of Cardiology Uzbekistan

Xoshimov Sh.U. - Republican Specialized Scientific and Practical Medical Center of Cardiology Uzbekistan

Karimov B.S. - Republican Specialized Scientific and Practical Medical Center of Cardiology Uzbekistan

Resume

Introduction. Modern ideas about the pathogenesis of CHF focus not only on systolic dysfunction of the left ventricle, but also on successive changes in the geometry, mechanics and deformation characteristics of other chambers of the heart. A comprehensive analysis of the deformation parameters of the LV, LP, and right ventricle (RV) allows for a more complete understanding of the stages of remodeling and functional changes in CHF. The aim of the study was to evaluate the features of global phased remodeling of the heart chambers in patients with chronic heart failure of ischemic origin, depending on the degree of decrease in the left ventricular ejection fraction, based on two-dimensional echocardiography data with analysis of myocardial deformity. Materials and methods: The study included 96 patients with an established diagnosis of chronic heart failure according to modern criteria. The patients were divided into three groups depending on the LVEF value: Group I – with LVEF > 50% (n= 46), patients with preserved systolic function; group II – with LVEF 40-49% (n=24), patients with moderate decrease in systolic function; group III – with LVEF < 40% (n=26), patients with severe decreased systolic function. global longitudinal deformation (GLS) of the left ventricle was significantly lower in patients with reduced ejection fraction (LVEF). Results. In the group with EF >50%, the average GLS value was 17.0 ± 2.8%, whereas with EF 40-49% and <40%, the values decreased to 12.6 ± 2.1% and 9.4 ± 2.2%, respectively (p < 0.001). A similar trend was observed for GLS measured in 4-, 2-, and 3-camera projections. The data indicate a high sensitivity of GLS to a decrease in myocardial contractile function and confirm its clinical significance in assessing the functional state of the left ventricle. The study of LP functions using two-dimensional speckle tracking EchoCG in the reservoir, conduit, and contractile phases also demonstrates a significant decrease in absolute values: LASr (reservoir phase) - 35.5 ± 8.3% (PV >50%) → 17,8 ± 11,2% ( PV <40%), p<0.001; LASct (conductive) -17,6 ± 5,4% → 8,8 ± 6,5%, p<0.001; LAScd (contractile)- 18,7 ± 5,9% → 8,7 ± 4,6%, p<0.001. In patients with an ejection fraction (EEF) of the left ventricle above 50%, the indices of longitudinal deformation of the right ventricle were the highest (RVFWLS — 21.3 ± 4.0%, RV GLS — 18.1 ± 3.2%), whereas with EEF 40-49% they decreased (respectively 19.9 ± 2.8% and 16.0 ± 2.7%), and with PV below 40% showed the most pronounced decrease (RVFWLS — 14.0 ± 4.1%, RV GLS — 10.5 ± 3.1%), with a significant difference between the groups (P=0.001). Conclusions: In patients with CHF of ischemic origin, there is a gradual remodeling of all chambers of the heart — LV, LP and RV — with an increase in the severity of functional disorders as the ejection fraction decreases. The global longitudinal strain (GLS) of the left ventricle, as well as the deformational parameters of the left atrium (LASr, LASct, LAScd) and the right ventricle (RVFWLS, RV GLS) demonstrate high sensitivity to changes in cardiac hemodynamics and can serve as early markers of CHF progression. Speckle-tracking echocardiography is an informative noninvasive method for assessing subclinical myocardial dysfunction and may be useful for risk stratification and monitoring the effectiveness of therapy in patients with CHF of varying severity.

Keywords: Speckle-tracking echocardiography, assessment of stage-by-stage cardiac remodeling, CHF of ischemic genesis

First page

481

Last page

491

For citation:Bekmetova F.M., Fozilov X.G., Bekbulatova R.Sh., Xoshimov Sh.U., Karimov B.S. - SPECKLE-TRACKING ECHOCARDIOGRAPHY IN THE ASSESSMENT OF STAGE-BY-STAGE CARDIAC REMODELING IN ISCHEMIC HEART FAILURE//New Day in Medicine 6(80)2025 481-491 https://newdayworldmedicine.com/en/new_day_medicine/6-80-2025

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