rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2020-11-04rpcardio-2352Research ArticleORIGINAL STUDIESОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯRole of Speckle Tracking in the Evaluation of Left Ventricular Remodeling After Streptokinase Infusion in Patients with Acute Anterior Myocardial InfarctionРоль speckle-tracking эхокардиографии в оценке ремоделирования левого желудочка после инфузии стрептокиназы у пациентов с острым передним инфарктом миокардаФарагШ. И.FaragSh. I.

Шерин Ибрагим Фараг - врач, кафедра сердечно-сосудистой медицины, медицинский факультет, Университет Бенха.13512, Бенха, ул. Фарид Нада.

Shereen Ibrahim Farag - MD, Cardiovascular Medicine Department, Faculty of Medicine, Benha University.Fareed Nada Street, Benha, Qalubiya Governorate, 13511.

dr.shereenfarag@gmail.comэль-РаббатХ. Э.El-RabbatKh. E.

Халед Эмад ад-Дин эль-Раббат - врач, кафедра сердечно-сосудистой медицины, медицинский факультет, Университет Бенха.13512, Бенха, ул. Фарид Нада.

Khaled Emad El-Din El-Rabbat - MD, Cardiovascular Medicine Department, Faculty of Medicine, Benha University.Fareed Nada Street, Benha, Qalubiya Governorate, 13511.

эль-АвадиМ. А.El-AwadiM. A.

Мохамед Али эль-Авади - бакалавр медицины и хирургии, кафедра сердечно-сосудистой медицины, медицинский факультет, Университет Бенха.13512, Бенха, ул. Фарид Нада.

Mohamed Ali El-Awadi - MBBCH, Cardiovascular Medicine Department, Faculty of Medicine, Benha University.Fareed Nada Street, Benha, Qalubiya Governorate, 13511.

СабриА. М.SabryA. M.

Аль-Шима Мохамед Сабри - врач, кафедра сердечно-сосудистой медицины, медицинский факультет, Университет Бенха.13512, Бенха, ул. Фарид Нада.

AL-Shimaa Mohamed Sabry - MD, Cardiovascular Medicine Department, Faculty of Medicine, Benha University.Fareed Nada Street, Benha, Qalubiya Governorate, 13511.

Университет БенхаЕгипетBenha UniversityEgypt202028122020166876880Copyright © Farag S.I., El-Rabbat K.E., El-Awadi M.A., Sabry A.M., 20202020Фараг Ш.И., эль-Раббат Х.Э., эль-Авади М.А., Сабри А.М.Farag S.I., El-Rabbat K.E., El-Awadi M.A., Sabry A.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/2352

Background. Left ventricular (LV) remodeling is an adverse consequence after acute myocardial infarction.Aim. To assess the role of speckle tracking in the evaluation of LV remodeling after streptokinase infusion in patients with acute anterior ST-segment elevation myocardial infarction (STEMI).Material and methods. A total of 200 patients with first acute anterior STEMI received streptokinase as a reperfusion therapy were included. Conventional echocardiography and speckle tracking were performed within 3 days of admission and 3 months later. According to the development of LV remodeling, patients were classified into two groups. Group (I) patients with LV remodeling (60 patients) and group (II) patients without remodeling (140 patients).Results. Patients with LV remodeling had lower global longitudinal (GLS) and circumferential (GCS) strain values (-13.19±4.57 vs. -18.90±4.23 % and -13.16±4.27 vs. -17.16±3.3 %, respectively, p<0.001). GLS cutoff value of >-13.5 was shown to have the best diagnostic accuracy (sensitivity =60.0% & specificity =87.1%) in predicting LV remodeling (AUC 0.816, 95% confidence interval [CI] 0.754-0.877, p<0.001). GCS cutoff value of >-16.21 was shown to have the best diagnostic accuracy (sensitivity =75.0% & specificity =71.4%) in predicting LV remodeling (AUC 0.785, 95%CI 0.719-0.85, p<0.001).Conclusion. Speckle tracking echocardiography either longitudinal or circumferential strain has good sensitivity and specificity in predicting LV remodeling after acute myocardial infarction.

Ремоделирование левого желудочка (ЛЖ) является неблагоприятным последствием острого инфаркта миокарда.Цель. Оценить роль speckle-tracking эхокардиографии в диагностике ремоделирования ЛЖ после применения стрептокиназы у пациентов с острым передним инфарктом миокарда с подъемом сегмента ST (ИМпБТ).Материал и методы. В исследование было включено 200 пациентов с впервые развившимся острым передним ИМпST, получивших стрептокиназу в качестве реперфузионной терапии. Традиционная эхокардиография и speckle-tracking эхокардиография проводились в течение трех дней от момента госпитализации и 3 мес спустя. В зависимости от развития ремоделирования ЛЖ пациенты были разделены на две группы: группа I - пациенты, у которых сформировалось ремоделирование (n=60), и группа II - пациенты, у которых ремоделирование ЛЖ не сформировалось (n=140).Результаты. У пациентов с ремоделированием ЛЖ отмечались более низкие показатели глобальных продольной (ГПД) и циркулярной (ГЦД) деформаций (-13,19±4,57 по сравнению с -18,90±4,23 % и -13,16±4,27 по сравнению с -17,16±3,3 %, соответственно, p<0,001). По нашим данным наибольшей диагностической точностью в прогнозировании развития ремоделирования ЛЖ обладали: ГПД>-13,5 (Area under curve [AUC] 0,816, 95% доверительный интервал [ДИ] 0,754-0,877, p<0,001, чувствительность 60,0%; специфичность 87,1%) и ГЦД>-16,21 (AUC 0,785, 95%ДИ 0,719-0,85, p<0,001, чувствительность 75,0%; специфичность 71,4%).Вывод. Speckle-tracking эхокардиография с оценкой ГПД и ГЦД продемонстрировала высокую чувствительность и специфичность в отношении прогноза развития ремоделирования ЛЖ после острого инфаркта миокарда.

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