Статья
ДЕФОРМАЦИЯ МИОКАРДА И ПОЛНАЯ БЛОКАДА ЛЕВОЙ НОЖКИ ПУЧКА ГИСА
Тканевое допплеровское изображение миокарда является полезным ультразвуковым инструментом для количественной оценки систолической и диастолической функции левого желудочка. В течение прошедших 10 лет оценка миокардиальной деформации стала возможной первоначально с помощью тканевого допплера и позднее — с применением недопплеровской методики «след пятна» (Speckle Tracking Imaging). Оценка деформации и скорости деформации является чувствительным индикатором субклинических состояний и широко используется для оценки механической диссинхронии. Блокада левой ножки пучка Гиса — частое, этиологически гетерогенное, клинически неблагоприятное и диагностически сложное состояние. Около 2% пациентов, подвергнутых стресс-тестированию, имеют стабильную или преходящую блокаду левой ножки пучка Гиса. Наличие блокады левой ножки пучка Гиса связано с низким или уменьшающимся диастолическим коронарным потоком особенно во время гиперемии. Стресс-эхокардиография является лучшим выбором в диагностике ишемической болезни сердца, хотя специфичность и чувствительность снижены у лиц с блокадой левой ножки пучка Гиса в бассейне передней нисходящей артерии при наличии исходной дискинезии межжелудочковой перегородки.
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