New views into the structural and functional state of the heart muscle and modern technologies for their assessment

Abstract

One of the most frequently used diagnostic methods for non-invasive assessment of morpho-functional changes in the heart is two-dimensional routine echocardiography, which enables visual and semi-quantitative assessment of global and regional cardiac contractility by observing the movement of myocardial segments. However, this method is somewhat dependent on the quality of technical performance and the qualifications of the doctor, which significantly determines the reliability of the results obtained. That is why new technologies are emerging in cardiac diagnostics, including tissue Dopplerography a type of Doppler study that studies the movement of the myocardium, valvular apparatus, and other tissues using lowfrequency and high-amplitude waves. Attempts to quantitatively assess the contractile function of the myocardium with tissue Doppler was not widely adopted because of technical problems - low sensitivity and dependence on the scanning angle, which contributed to the emergence of a new modification of two-dimensional echocardiography - Speckle Tracking - 2D Strain (STE) in the field of diagnostics in contemporary practice. The present work presents a literature review of modern views on the structuralfunctional organization of the heart based on the concept of the spiral structure of the heart muscle and the use of a new method of their assessment, Speckle Tracking - 2D Strain Echocardiography, which enables the elucidation of the pathophysiological mechanisms of left ventricular (LV) dysfunction by assessing myocardial deformation and the early detection of asymptomatic stages of systolic and diastolic cardiac dysfunction in the preclinical stage