Diagnosis of systolic myocardial dysfunction: analysis of myocardial deformity

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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