EART HEMODYNAMICS IN EARLY PERIOD OF ACUTE ST ELEVATION ANTERIOR MYOCARDIAL INFARCTION BY 2D SPECKLE TRACKING ECHOCARDIOGRAPHY

Aim. To assess the changes in biomechanics of the heart at early stages post-acute ST-elevation myocardial infarction (MI) by 2D speckle tracking echocardiography.

Material and methods. Totally, 35 patients included (mean age — 58,46±10,2 year old) with acute Q-MI admitted within 24 hours from the disease onset. Echocardiography, including 2D speckle tracking regimen was done at the 3rd (T1), 7th (T2) and 14th (T3) day post-MI (Vivid E9 device). Patients were selected to two groups: with an adverse remodeling of the left ventricle (LVR+) by 14th day and without (LVR-).

Results. Urgent reperfusion was done in all patients, and in 72% within 6 hours. There was no significant dynamics of the standard echocardiography parameters — enddiastolic volume (EDV) and end-systolic volume (ESV), ejection fraction (EF), index of local contractility disorder (ILCD) of theLV.There was improved deformity — 2D global longitudinal strain (GLS) by T2 (p=0,048). Apical and basal rotation — without dynamics during all follow-up period. However, number of patients with normal and decreased value of basal rotation and its systolic velocity, as with normal and increased value of apical rotation and its systolic velocity, increased by T3 (p<0,05). There was increase of systolic twist velocity by T3. In LVR+ group there was improvement of ILCD and 2D GLS by T3. Systolic velocity of apical rotation and twist increased by T3, however all velocity parameters were significantly lower than in LVR-. Clinically the groups differed by the time of reperfusion: 5,48±3,58 vs 3,89±2,25 hours (р><0,05). Conclusion. Changes in biomechanics of the heart by 2D speckle tracking echocardiography in patients with the use of modern and on-time pharmacoinvasive strategy at early post-infarction period represented the restoring of cardiac function, while standard parameters (ESV, EDV, EF LV) did not show dynamics. Improvement of 2D GLS was found even at T2 point. Among the values reflecting rotational characteristics of LV, the systolic velocity of apical rotation by T3. There was no dynamics in basal and apical rotation. The number of patients increased, with normal and increased apical rotation, as with decreased and normal basal rotation >< 0,05).

Conclusion. Changes in biomechanics of the heart by 2D speckle tracking echocardiography in patients with the use of modern and on-time pharmacoinvasive strategy at early post-infarction period represented the restoring of cardiac function, while standard parameters (ESV, EDV, EF LV) did not show dynamics. Improvement of 2D GLS was found even at T2 point. Among the values reflecting rotational characteristics ofLV, the systolic velocity of apical rotation by T3. There was no dynamics in basal and apical rotation. The number of patients increased, with normal and increased apical rotation, as with decreased and normal basal rotation by T3. In LVR+ group myocardial reperfusion was achieved significantly later, there was improvement of 2D GLS and ILCD of LV by T3, as well as velocity values of apical rotation and twist.

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