Non-compact right ventricular myocardium is a rare type of cardiomyopathy, it usually results from arrested myocardial development during embryogenesis. This disease can be characterized by excessive prominent trabeculations and deep inter-trabecular recesses in the ventricular wall. It might be a component of biventricular non-compact cardiomyopathy or an isolated form. The article presents a review of the literature on the clinic and radiation diagnostics of non-compact right ventricular myocardium with the presentation of the issues of differential diagnosis.

Aim. To analyze ischemic and reperfusion injury characteristics, as well as myocardial performance, to identify predictors of reduced left ventricular (LV) ejection fraction (EF) <50% 24 weeks after ST-segment elevation myocardial infarction (STEMI) in patients who underwent revascularization.Material and methods. The study included were 65 patients (age 58 (52; 60) years), who were examined on days 7-10 and after 24 weeks. Based on cardiac magnetic resonance imaging (MRI), parameters of ischemic and reperfusion injury were determined. Speckle tracking echocardiography was used to evaluate the myocardial function.Results. All 65 patients completed the study. Based on echocardiography, patients were divided into following groups: 1 — 45 people with LVEF ≥50%, 2 — 20 patients with LVEF <50%. In patients with LVEF ≥50% 24 weeks after STEMI, there was a decrease in the ischemia injury mass by 32,3% (p=0,001) due to regression of the scar mass by 28% (p=0,008) and the peri-infarct heterogeneous zone by 33,3% (p=0,020). In group 2, the indicators did not change. At the repeat visit, there was a decrease in the number of people with microvascular obstruction in the group of LVEF ≥50% from 44 to 16% (p<0,001), while in LVEF <50% — from 65 to 40% (p=0,045). According to echocardiography, global wasted work in group 1 decreased from 77 (50,5; 105,5) to 59 (43; 92) mm Hg% (p=0,042), while in group 2, it increased from 99,5 (59; 181) to 104,5 (58,5; 156,5) mm Hg% (p=0,765). Global work efficiency and global work index prevailed in patients with LVEF ≥50% at two visits (p<0,05). The following predictors of decreased LVEF were determined 24 weeks after STEMI: ischemia injury mass, scar tissue, microvascular obstruction, global contrast index according to MRI; global work efficiency and global work index on echo cardiography.Conclusion. Contrast-enhanced cardiac MRI and speckle tracking echocardiography are complementary methods that allow quantitative morphofunctional assessment of post-infarction cardiosclerosis and predict the development of mildly reduced and reduced LVEF in the medium term.

Aim. To assess early predictors of pathological remodeling in patients after ST-elevation myocardial infarction (STEMI) using speckle-tracking echocardiography (STE).Material and methods. The study included 114 STEMI patients aged 52 (44; 58) years. A two-dimensional echocardiography was performed with the analysis of standard parameters and STE with an analysis of strain and rotational characteristics of the myocardium. In addition, brain natriuretic peptide and troponin-I concentration was determined. The development of pathological post-infarction remodeling within 12-month follow-up was assessed as an end point. Depending on the outcome, 2 groups were formed: group 1 — patients with pathological remodeling (PR), n=45 (39,5%), group 2 — patients without PR, n=69 (60,5%).Results. Early remodeling was detected in 24 (53,3%) people, mid-term — in 15 (33,4%), and late remodeling — in 6 (13,3%). In the PR group, heart failure (HF) was detected in 100% of patients, while in non-PR group, 23 (33,3%) patients had no signs of HF.In the early period of myocardial infarction, each of following indicators with high sensitivity and specificity predicts postinfarction pathological dilatation: global longitudinal strain (GLS) <11,7%, global circular strain (GCS) <12,4%, and a Twist decrease to 7,8^o. A multivariate logistic regression model was created for the formation of pathological remodeling in patients with STEMI, which included GLS, global radial deformation (GRS), end-systolic volume index (ESVI), determined on days 7-9 of STEMI.Conclusion. GLS, GCS, and left ventricular Twist are independent highly sensitive and specific predictors of pathological remodeling. The following early predictors of postinfarction pathological dilatation have been established: reduced GLS in combination with higher GRS and left ventricular ESVI.

Комплексная модель многофакторного прогнозирования жизнеугрожающих желудочковых нарушений ритма у больных инфарктом миокарда

Background/Objectives: The aim of this study is to identify markers and develop a multifactorial model for characterizing extensive scar tissue after revascularization in patients with myocardial infarction (MI). Methods: A total of 123 patients with MI were examined. The patients underwent contrast-enhanced cardiac magnetic resonance imaging (MRI) with a 1.5 Tesla GE SIGNA Voyager (GE HealthCare, Chicago, IL, USA) on the 7th–10th days from the onset of the disease. At the first stage, we performed a comparative analysis and built a multifactorial model based on the examination results of 92 (75%) patients enrolled from April 2021 to October 2023. These patients formed the group used for model development, or the “modeling group”. The mass of the scar was calculated, including relative to the left ventricular (LV) myocardium mass (M_scar/LVMM, in %). Results: The first subgroup consisted of 36 (39%) patients with a large scar, denoted as “LS” (M_scar/LVMM > 20%). The second subgroup included 56 (61%) patients with a smaller scar, referred to as “SS” (M_scar/LVMM ≤ 20%). Logistic regression was used to identify independent factors affecting scar tissue size. A multifactorial model was created. This model predicts M_scar/LVMM > 20% on MRI. It uses readily available clinical parameters: high-sensitivity troponin I (HscTn I) and N-terminal pro B-type natriuretic peptide (NT-proBNP) levels, and LV relative wall thickness (RWT). We tested the multifactorial model on the “modeling group” (n = 31). The sensitivity was 63.6% and the specificity was 85.7%. Conclusions: These indicates the feasibility of its application in clinical practice.

The aim of this study is to identify markers and develop a multifactorial model for characterizing extensive scar tissue after revascularization in patients with myocardial infarction (MI). 123 patients with MI were examined. The patients underwent contrast-enhanced cardiac magnetic resonance imaging (MRI) with a 1.5 Tesla GE SIGNA Voyager (GE HealthCare, USA) on the 7th-10th days from the onset of the disease. At the first stage, we performed a comparative analysis and built a multifactorial model based on the examination results of 92 (75%) patients enrolled from April 2021 to October 2023. These patients formed the group used for model development, or the “modeling group”. The mass of the scar was calculated, including relative to the left ventricular (LV) myocardium mass (Mscar/LVMM, in %). The first subgroup consisted of 36 (39%) patients with a large scar, denoted as “LS” (Mscar/LVMM >20%). The second subgroup included 56 (61%) patients with a smaller scar, referred to as “SS” (Mscar/LVMM ≤20%). Logistic regression was used to identify independent factors affecting scar tissue size. A multifactorial model was created. This model predicts Mscar/LVMM >20% on MRI. It uses readily available clinical parameters: high-sensitivity troponin I (HscTn I) and N-terminal pro B-type natriuretic peptide (NT-proBNP) levels, and LV relative wall thickness (RWT). We tested the multifactorial model on the “modeling group” (n=31). The sensitivity was 63.6%, and the specificity was 85.7%. This indicates the feasibility of its application in clinical practice.