medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»medalphabet-379Research ArticleСтатьиВозможности современной стресс-эхокардиографии при аортальных порокахClinical use of modern stress echocardiography n aortic valve diseases summaryБартош-ЗеленаяС. Ю.Bartosh-ZelenayaS. J.noemail@neicon.ruНайденТ. В.NaidenT. V.noemail@neicon.ruГусеваО. А.GusevaO. A.noemail@neicon.ruАндрееваА. Е.AndreevaA. E.noemail@neicon.ruФГБОУ ВО «Северо-Западный Государственный медицинский университет им. И. И. Мечникова»РоссияNorth-Western State Medical University named by. I. I. MechnikovRussian Federation201718122017339Современная функциональная диагностика3945Copyright © Бартош-Зеленая С.Ю., Найден Т.В., Гусева О.А., Андреева А.Е., 20172017Бартош-Зеленая С.Ю., Найден Т.В., Гусева О.А., Андреева А.Е.Bartosh-Zelenaya S.J., Naiden T.V., Guseva O.A., Andreeva A.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/379

Настоящий обзор содержит современные представления о возможностях стресс-эхокардиографии (стресс-ЭхоКГ) при аортальных пороках. Приведены показания к проведению нагрузочного тестирования, алгоритм исследования, ключевые параметры, подлежащие обязательной оценке и способы интерпретации результатов. Особое внимание уделено оценке тяжести низкоградиентного аортального стеноза. С позиций современных рекомендаций рассмотрена тактика лечения пациентов с аортальными пороками, показания к кардиохирургическим, в том числе малоинвазивным вмешательствам.

Current review contains actual data concerning the role of stress echocardiography in aortic valve diseases. The indications for stress testing, main objectives, test procedure, most important parameters for assessment and principles of interpretation are discussed. Particular attention is paid to assessment the severity of low gradient aortic stenosis. The strategy of treatment of patients with aortic valve diseases, indications for valve surgery, including transcathether interventions, are summarized.

стресс-эхокардиографияаортальный стенознизкоградиентный аортальный стенозаортальная недостаточностьконтрактильный резервstress echocardiographyaortic stenosisaortic insufficiencycontractile reservelow-flowlow-gradient aortic stenosisReferencesG. Benfari, A.M. Gori, A. Rossi et al. Feasibility and relevance of right parasternal view for assessing severity and rate of progression of aortic valve stenosis in primary care. International Journal of Cardiology. 2017; 240: 446-451.G. Benfari, A.M. Gori, A. Rossi et al. Feasibility and relevance of right parasternal view for assessing severity and rate of progression of aortic valve stenosis in primary care. International Journal of Cardiology. 2017; 240: 446-451.Clavel M.A., Ennezat P. V., Marechaux S. et al. Stress echocardiography to assess stenosis severity and predict outcome in patients with paradoxical low-flow, low-gradient aortic stenosis and preserved LV EF. Journal of American College of Cardiology: Cardiovascular Imaging. 2013; 6: 175-183.Clavel M.A., Ennezat P. V., Marechaux S. et al. Stress echocardiography to assess stenosis severity and predict outcome in patients with paradoxical low-flow, low-gradient aortic stenosis and preserved LV EF. Journal of American College of Cardiology: Cardiovascular Imaging. 2013; 6: 175-183.Dahou A., Bartko P. E., Capoulade R. et al. Usefulness of global left ventricular longitudinal strain for risk stratification in low ejection fraction, low-gradient aortic stenosis: results from the multicenter true or pseudo-severe aortic stenosis study. Circulation: Cardiovascular Imaging. 2015; 8:211-217.Dahou A., Bartko P. E., Capoulade R. et al. Usefulness of global left ventricular longitudinal strain for risk stratification in low ejection fraction, low-gradient aortic stenosis: results from the multicenter true or pseudo-severe aortic stenosis study. Circulation: Cardiovascular Imaging. 2015; 8:211-217.Donal E., Thebault C., O’Connor K. et al. Impact of aortic stenosis on longitudinal myocardial deformation during exercise. European Journal of Echocardiography. 2011; 12:235-241.Donal E., Thebault C., O’Connor K. et al. Impact of aortic stenosis on longitudinal myocardial deformation during exercise. European Journal of Echocardiography. 2011; 12:235-241.Lancellotti P., Pellikka P. A., Budts W. EACVI/ ASE clinical recommendations. The use of stress echocardiography in non-ischaemic heart disease. Journal of American Society of Echocardiography. 2017; 30: 101-138.Lancellotti P., Pellikka P. A., Budts W. EACVI/ ASE clinical recommendations. The use of stress echocardiography in non-ischaemic heart disease. Journal of American Society of Echocardiography. 2017; 30: 101-138.Marechaux S., Hachicha Z., Bellouin A. et al. Usefulness of exercise-stress echocardiography for risk stratification of true asymptomatic patients with aortic valve stenosis. European Heart Journal, 2010; 31:1390-1397.Marechaux S., Hachicha Z., Bellouin A. et al. Usefulness of exercise-stress echocardiography for risk stratification of true asymptomatic patients with aortic valve stenosis. European Heart Journal, 2010; 31:1390-1397.Nishimura R. A., Otto C.M., Sorajja P. et al. AHA/ACC Guideline for the management of patients with valvular heart disease. Circulation. 2014; 129(23):2441-2488.Nishimura R. A., Otto C.M., Sorajja P. et al. AHA/ACC Guideline for the management of patients with valvular heart disease. Circulation. 2014; 129(23):2441-2488.Nishimura R. A., Otto C. M., Bonow R. O. et al. AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of American College of Cardiology. 2017; 70(2): 254-289.Nishimura R. A., Otto C. M., Bonow R. O. et al. AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of American College of Cardiology. 2017; 70(2): 254-289.Tribouilloy C., Levy F., Rusinaru D. et al. Outcome after aortic valve replacement for lowflow/low-gradient aortic stenosis without contractile reserve on dobutamine stress echocardiography. Journal of American College of Cardiology. 2009; 53:1865-1873.Tribouilloy C., Levy F., Rusinaru D. et al. Outcome after aortic valve replacement for lowflow/low-gradient aortic stenosis without contractile reserve on dobutamine stress echocardiography. Journal of American College of Cardiology. 2009; 53:1865-1873.Vahanian A., Alfieri O., Andreotti F. et al. Guidelines on the management of valvular heart disease. European Heart Journal, 2012; 33:2451-2496.Vahanian A., Alfieri O., Andreotti F. et al. Guidelines on the management of valvular heart disease. European Heart Journal, 2012; 33:2451-2496.

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