SPECKLE-TRACKING ECHOCARDIOGRAPHY FOR EARLY DETECTION OF SUBCLINICAL SYSTOLIC DYSFUNCTION IN PERIMENOPAUSAL WOMEN WITHOUT APPARENT DIASTOLIC DYSFUNCTION.

Abstract

In the era of advanced technologies and improvement of each branch of medicine, thanks to advances in technology and clinical research, new preventive and therapeutic strategies have been developed for cardiovascular diseases. Speckle tracking study is no exception.

The aim of the study: to assess the need for the introduction of speckle tracking echocardiography in conjunction with a routine method for the early diagnosis of any myocardial dysfunction, including the left atrium in females, in particular in the peripausal period.

Materials and methods: This study had a prospective design with an observation period of one year. The study involved 150 female patients, aged 47 to 53 years, with a known hormonal level, in accordance with the peripausal period. The study was conducted at the BMC of the Presidential Affairs Administration of the Republic of Kazakhstan, Department of Functional Diagnostics. All tests were performed using IBM SPSS Statistics 20 (IBM, USA) with a confidence level of 95%.

Results of the study: All 150 subjects underwent routine echocardiography, after which we divided them into two main groups: 90 women (60%) formed a cohort of individuals with existing left ventricle (LV) diastolic dysfunction, the remaining 60 women, or 40%, were individuals without existing LV diastolic dysfunction. Speckle tracking echocardiography was performed. During the study, in the cohort of individuals with left ventricle diastolic disfunction (LVDD) according to the results of routine echocardiography, 85 patients out of 90 patients had basal segment systolic dysfunction. This amounted to 94.5% of patients. In the remaining 5 patients (5.5%), no regressive changes in systole were detected. In the second cohort of sixty women with no LVDD on routine echocardiography, only 50, or 83.4%, had normal systolic function on the basal section. The remaining 16.6% - 10 patients, without changes in diastolic function on routine echocardiography, showed systolic dysfunction and pre-diastolic pathology during the speckle tracking echocardiography (ST-ECHO) examination.

Conclusions: The routine echocardiography method in our study showed that it often cannot be a method for preventing the development of myocardial systolic dysfunction in individuals with existing diastolic dysfunction of the left ventricle myocardium. A direct relationship was found between the presence of LV systolic dysfunction of the basal layers on speckle tracking echocardiography examination in women even without pronounced LV diastolic dysfunction. Thus, left ventricle diastolic disfunction accompanies left ventricle systolic disfunction (LVSD) in almost 60% of cases. This means that it is mandatory and recommended to introduce ST-ECHO to the routine examination of echocardiography, as an informative method-predictor of further adverse cardiovascular events.