perinatologyРоссийский вестник перинатологии и педиатрииRossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics)1027-40652500-2228Ltd. “The National Academy of Pediatric Science and Innovation”10.21508/1027-4065-2018-63-2-53-57perinatology-645Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESДиагностика систолической миокардиальной дисфункции: анализ деформации миокардаDiagnosis of systolic myocardial dysfunction: analysis of myocardial deformityГрозноваО. С.GroznovaO. S.

д.м.н., вед. н.с. отдела детской кардиологии и аритмологии

ЧерныхН. Ю.ChernykhN. Yu.

аспирантка

ТарасоваА. А.TarasovaA. A.

д.м.н., проф. кафедры ультразвуковой диагностики детского возраста

ОСП «Научно-исследовательский клинический институт педиатрии им. академика Ю.Е. Вельтищева» ФГБОУ ВО РНИМУ им. Н.И. Пирогова Минздрава России, МоскваРоссияVeltischev Research and Clinical Institute for Pediatrics of the Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation, MoscowRussian FederationФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, МоскваРоссияRussian Medical Academy of Continuous Vocational Education of the Ministry of Health of the Russian Federation, MoscowRussian Federation2018270420186325357Copyright © Ltd. “The National Academy of Pediatric Science and Innovation”, 20182018Ltd. “The National Academy of Pediatric Science and Innovation”Ltd. “The National Academy of Pediatric Science and Innovation”https://www.ped-perinatology.ru/jour/about/submissions#copyrightNoticehttps://www.ped-perinatology.ru/jour/article/view/645

Современным высокоинформативным методом функциональной диагностики миокарда является исследование миокардиального стрейна, т.е. изменения геометриимиокарда, оцениваемого в разных направлениях. В стрейне выделяют деформацию (изменение стартовой, или исходной геометрии) и перформацию (восстановление исходной геометрии). Рассмотрены стадии развития систолической миокардиальной дисфункции (ранняя, развернутая и стадия декомпенсации), а также процессы, протекающие в каждой стадии в миокарде. Самые ранние проявления систолической миокардиальной дисфункции – снижение показателей продольного стрейна и компенсаторное повышение показателей циркулярного (и радиального) стрейна. Снижение глобальной фракции выброса выявляется только на стадии декомпенсации. Приведены нормативные данные о величине продольного, радиального и циркулярного стрейна у взрослых, а также собственные данные о  величине радиального и  продольного стрейна у  детей. При  обследовании 37 детей в  возрасте от  7 до 17 лет без заболеваний миокарда сегментарный радиальный стрейн в среднем составил 34±9% (нижняя граница нормы 20%). Достоверных различий в величине сегментарного радиального стрейна в группах детей в возрасте 7–11 и 12–17 лет, а также в группах детей с площадью поверхности тела от 0,65 до 1,3 м2 и от 1,31 до 1,73 м2 выявлено не было. Нижняя граница нормы для продольного стрейна в исследуемой группе составила –20%.

 

A modern highly informative method for the functional diagnosis of the myocardium is the study of the myocardial strain, i.e. changes in the geometry of the myocardium, evaluated in different directions. In the strain, the deformation (change of the starting, or initial geometry) and the transformation (restoration of the original geometry) are distinguished. The stages of development of systolic myocardial dysfunction (early, deployed and decompensation stages), as well as the processes in the myocardium at each stage were studied. The earliest manifestations of systolic myocardial dysfunction are a decline in the longitudinal strain and compensatory increase in performance of the circular(and radial)strain. The reduction of the global ejection fraction isrevealed only at the stage of decompensation. The standard data on the magnitude of the longitudinal, radial and circular strain in adults are given, as well as own data on the magnitude of the radial and longitudinal strain in children. In 37 children without myocardial diseases at the age from 7 to 17 years, segmental radialstrain on the average was 34±9% (the lowerlimit of the norm is 20%). No significant differencesin the magnitude of radialsegmental strain in groups of children aged 7–11 and 12–17, as well as in the groups of children with body surface area from 0.65 to 1.3 m2 and from 1.31 to 1.73 m2 were revealed. The lowerlimit of the norm for the longitudinalstrain in the study group was –20%.

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