NEW ECHOCARDIOGRAPHIC METHODS IN DETERMINING THE HEART INSUFFICIENCY BASED ON 3D SPECKLE TRACKING TECHNOLOGY. THE SYSTOLIC HEART FAILURE (SHF) AND DIASTOLIC HEART FAILURE (DHF). THE DIFFERENCES

Fatmir Ferati, Anida Ferati, Mentor Karemani, ArdianPreshova

Abstract

The purpose of the study is to analyze the differences in myocardial deformation through the 3D Strain analysis between the patients with systolic heart failure (SHF), patients with diastolic heart failure (DHF) as well as patients with no changes in the heart function. The ejection fraction (EF) was determined with 2D EF as well as 3D EF. 3D strain was analyzed through global longitudinal strain (GLS), global circumferential global strain (GCS), torso and the left ventricular muscle (VM) twist. The differences of the parameters between the population with normal EF were analyzed (EF>50%), however with signs of diastolic heart failure (DHF), as well as cardiac insufficiency patients and EF, 50% (SHF). As an initial value for analysis was taken the 2D EF measured with the Simpsons modified formula (%) as well as the patient’s clinical symptoms. In this paper are studied the end-diastolic as well as measurements of the left ventricle in the three groups of patients. The 2D EF, 3DEF, 3D strain values were analyzed in these three groups of patients. As a referential initial value was taken the 2D EF above or under 50%, 3D EF expressed in %, GLS (the nominal value taken -15,9%) GCS with a normal value of -20, 8%. For twist as normal value was taken above 9.5, whereas for torso >1,51’/cm. Patients with cardiac insufficiency, but with EF above 50% for analysis were taken based on the anamnesis as well as values gained in treadmill stress ECG under 5,5METS(NYHA II). During the analysis of the results gained in these three groups, one can clearly see that the GLS values, as well as GCS in patients with EF under 50% and those above 50%, are lower in the population with no signs of cardiac insufficiency. Based on these data it is clear that these parameters can be used for diagnosing the classic cardiac insufficiency (with EF under 50%) as well as in people with cardiac insufficiency but with the same systolic function (EF above 50%) From the gained results one can prove that the GLS is lower in the two groups of patients with cardiac insufficiency, whereas GCS in patients with DSF has a clear decrease of GLS, whereas GCS is in the normal grounds. The importance of measuring these parameters, except for the difference in DHF is that people with decrease of all parameters of GLS and GCS which suggests longitudinal fiber damage and circumferential, possibility of improving the heart function is lower because of the more massive damage unlike those with damaged GLS only.

Pages: 27 - 31