International Medical Journal, Vol. 22., Iss. 1, 2016, P. 21−26.
STRUCTURAL AND FUNCTIONAL STATE OF THE MYOCARDIUM IN PATIENTS WITH HYPERTENSION AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Kharkiv National Medical University, Ukraine
The left ventricle (LV) is one of the main target organs of hypertension. echocardiography plays a prognostic role in this case. Assessment of LV hypertrophy and LV systolic and diastolic function is based on measurement of LV mass, geometry, and function. The value of echocardiography as a research tool in cardiology is uncontested. Quantification of cardiac chamber size and function is the corner stone of cardiac imaging. Echocardiography has a unique ability to provide noninvasive real−time images of the beating heart. Morbidity and mortality in patients with chronic obstructive pulmonary disease (COPD) is associated with cardiovascular diseases and often complicated by right−sided heart failure. However, RV assessment can be challenging. Doppler echocardiography cannot measure hemodynamic parameters but only provide an estimate of them. Therefore, the main limitation of this study is the lack of true hemodynamic data. Doppler echocardiography allows measurement of pulmonary artery systolic pressure, this modality is often problematic in patients with COPD because of lung hyperinflation and difficulty in obtaining clear acoustic windows. Although transthoracic echocardiography is an excellent noninvasive screening test for chronic heart failure (CHF), a high clinical index of suspicion is necessary to detect the disease before irreversible pathophysiologic changes occur. Despite multiple studies, many issues of the LV and RV structure and function remain open. In conclusion, noninvasive assessment of LV and RV systolic and diastolic function by strain and strain rate independently predicts future heart failure. New ultrasound technologies such as speckle−strain may play an important role in predicting prognosis and detecting preclinical stages of disease in CHF.
Key words: echocardiography, hypertension, chronic obstructive pulmonary disease.