Objective — To study the diagnostic value of left atrial (LA) compliance using transthoracic echocardiogram (TTE) at rest in determining of the heart failure with preserved ejection fraction (HFpEF) depending on the result of diastolic stress test (DST). Materials and Methods — We examined 200 patients (46.5% men, 66.0±5.8 years of age). Patients with elevated left ventricular (LV) filling pressure according to TTE at rest constituted Group I (n=34). Patients with impaired diastolic reserve according to DST constituted Group II (n=68); patients without HFpEF were placed in Group III (n=98). Speckle tracking echocardiography was used to assess left atrial reservoir strain (LASr). Results — The groups were similar in terms of key clinical characteristics, with the exception of coronary artery disease (79.4% vs. 86.8% vs. 66.7%, respectively, p=0.011) and NYHA heart failure class (2.0±0.6 vs. 1.9±0.4 vs. 1.7±0.6; p=0.002). Statistically significant differences were also found in NT-proBNP (500.0 [261.3;817.0] pg/ml vs. 256.7 [93.9;456.3] pg/ml vs. 183.8 [60.1;310.4] pg/ml, p<0.001) and both pre-test scoring scales, HFA-PEFF (6.0 [5.0;6.0] vs. 5.0 [4.0;6.0] vs. 4.0 [3.0;5.0], p<0.001) and H2FPEF (5.0 [3.0;6.0] vs. 5.0 [3.0;5.0] vs. 4.0 [3.0;5.0], p=0.001). Statistically significant differences between Groups I and II and Groups I and III were detected for most echocardiographic parameters. No significant differences were found between Groups II and III, except for the following parameters: E/e’ (11.2 [9.8; 12.6] vs. 9.3 [7.7; 10.9], respectively, p<0.001), LASr (21.4 [19.8; 24.5] % vs. 27.6 [24.6; 29.8] %, p < 0.001) and LA compliance (2.0 [1.6; 2.4] vs. 3.0 [2.4; 3.7], p<0.001). According to ROC analysis, the largest area under the curve (AUC), as well as optimal sensitivity and specificity in determining HFpEF in Groups II and III, were observed for LA compliance (AUC=0.837, p<0.001; 76.5% and 76.5%). Lower classification quality was demonstrated by the left atrial volume index (LAVI)/LASr (AUC=0.720, p<0.001; 69.1% and 62.2%), H2FPEF scale (AUC=0.629, p=0.006; 60.3% and 65.3%), NT-proBNP (AUC=0.615, p=0.014; 60.0% and 58.1%), and HFA-PEFF score (AUC=0.610, p=0.019; 60.3 and 54.1%). Conclusion — LA compliance with the cutoff point <2.4 has the highest ability to detect HFpEF depending on the DST result among all pre-test diagnostic tools.

Aim: to study the dynamics of clinical and echocardiographic parameters in patients with cardiovascular diseases (CVD) at 3, 12, and 26 months after COVID-19 pneumonia. Material and methods. The dynamics of clinical and echocardiographic parameters were studied in 130 patients with CVD at 3, 12, and 26 months after COVID-19 pneumonia (57 ± 8 years old, 46.9 % males). Results. Between the 1st and 2nd visits, body mass index (BMI) increased (30.6 ± 5.1 kg/m2 vs. 31.4 ± 5.4 kg/m2, p < 0.001), the number of patients with obesity of grades 2 –3 increased (14.6 % vs. 23.1 %, p < 0.001). Early diastolic septal mitral annular velocity decreased from the 2nd to the 3rd visit (7.0 [6.0; 8.0] cm/s vs. 6.0 [5.0; 8.0] cm/s, p = 0.023), as did the maximum diastolic lateral tricuspid annular velocity (12.0 [11.0; 14.0] cm/s vs. 8.0 [6.0; 9.0] cm/s, p < 0.001). Between the 2nd and 3rd visits, the average global longitudinal strain of the left ventricle increased ( –19.3 ± 2.6 % vs. –19.8 ± 2.2 %, p = 0.034), the frequency of detecting its reduced values decreased (34.9 % vs. 17.4 %, p = 0.003). Conclusion. In the long term after COVID-19 pneumonia, patients with CVD show an increase in BMI accompanied by worsening of diastolic ventricular function parameters without signifi cant progression in the frequency and severity of CVD.

Aim To study the relationship between laboratory markers and echocardiography (EchoCG) parameters in heart failure with preserved ejection fraction (HFpEF) depending on the results of the diastolic stress test (DST). Material and methods The diagnostic algorithm provided by the current guidelines for the assessment of left ventricular (LV) diastolic function was used to select patients. If there were not enough criteria to make a conclusion about increased LV filling pressure (FP) based on standard resting echocardiography data in patients with arterial hypertension and ischemic heart disease, DST was performed to detect HFpEF. 80 patients (50.0 % men, mean age 66.3 +/- 5.4 years) were included. Group 1 consisted of 41 patients with a positive DST, and group 2 included 39 patients with a negative DST. Concentrations of the markers of immune inflammation, endothelial dysfunction, collagen homeostasis, and myocardial stress were measured. Results The DST showed significant differences in the E / e' ratio (15.1 [13.4; 15.9] in group 1 and 9.5 [7.9; 10.3] in group 2, respectively, p<0.001) and the diastolic functional reserve index (DFRI) (9.8 [6.8; 14.0] and 21.0 [13.0; 29.0], p < 0.001). Resting EchoCG revealed significant differences in the left atrial reservoir strain (LASr) (22.8 [19.6; 25.6] % and 28.0 [24.8; 30.2] %, p<0.001) and the left atrial stiffness index (LASI) (0.50 [0.40; 0.57] and 0.34 [0.27; 0.41], p<0.001). In patients with HFpEF, the laboratory parameters of collagen regulation had the greatest number of relationships. Correlations were found between the concentrations of matrix metalloproteinase-9 and other biomarkers, including interleukin-10 (IL-10) (r=0.311; p=0.048), myeloperoxidase (r=0.382; p=0.014), N-terminal propeptide ofprocollagen type I (procollagen IN-terminal propeptide, PINP) (r=0.722; p<0.001) and type III (r=0.591; p<0.001), C-terminal propeptide of procollagen type I (r=0.330; p=0.035), tissue inhibitor of metalloproteinases type 1 (r=0.410; p=0.008), EchoCG parameters, including left atrial volume index (LAVI) (r=0.414; p=0.007) and DFRI (r=0.354; p=0.025). In addition, correlations were found for the concentrations of PINP with IL-10 (r=0.401; p=0.009) and endothelin-1 (r= -0.337; p=0.031); PINP with LAVI (r=0.498; p=0.001) and DFRI (r=0.420; p=0.007). Conclusion Patients with HFpEF have a greater number of relationships between markers of collagen homeostasis disorders and EchoCG parameters characterizing an increase in LV FP.

Aim. To study the diagnostic value of the left atrial stiffness index (LASI) of heart failure with preserved ejection fraction (HFpEF) depending assessed by transthoracic echocardiography (TTE) in the diagnosis on diastolic stress test (DST) results.Material and methods. DST was performed in cases of insufficient criteria for increased left ventricular filling pressure assessed by TTE. One hundred patients were examined (52,0% men, 66,1±5,4 years). Patients with a ratio of early transmitral flow velocity to early diastolic mitral annulus velocity (E/e') ratio >15 in DST were included in group I (n=45), patients with E/e' <15 — group II (n=55). The speckle tracking echocardiography was used to assess left atrial reservoir strain (LASr).Results. Significant differences were identified between the groups in sex (40,0% of men in group I and 61,8% in group II, respectively; p=0,044), body mass index (32,9 [29,5;36,0] and 29,6 [27,3;31,8] kg/m2; p=0,001), hypertension stage (2,9±0,3 and 2,5±0,8, p=0,037), the presence of coronary artery disease (88,9 and 67,3%; p=0,016), NYHA heart failure class (2,0±0,4 and 1,5±0,7; p=0,003). TTE re­vealed significant differences in the left atrium volume index (31,9 [28,5;36,0] and 27,8 [24,1;34,6] ml/m2; p=0,039), E/e' ratio (10,9 [9,7;12,5] and 9,3 [7,4;10,8]; p<0,001), LASr (23,5 [19,3;28,3] and 28,9 [25,6;32,2]%, p<0,001) and LASI (0,46 [0,38;0,56] and 0,30 [0,25;0,39]; p<0,001). According to ROC analysis, the largest area under the curve (AUC), optimal sensitivity and specificity in HFpEF diagnosis were observed in LASI (AUC=0,829, p<0,001; 77,8 and 74,5%, respectively). Lower classification quality was shown by the H2FPEF score (AUC=0,701, p=0,001; 66,7 and 69,1%), while the HFA-PEFF score was not significant in the pretest detection of HFpEF (AUC=0,608, p=0,065; 53,3 and 61,8%).Conclusion. LASI with a cut-off point >0,38 has the greatest ability to detect HFpEF among the possible pretest diagnostic methods.

Aim. To study changes in the brachial – ankle pulse wave velocity (baPWV), ankle – brachial index (ABI), diastolic function, and global longitudinal strain of the left ventricle (LV) 3 and 12 months after COVID-19 pneumonia.Materials and methods. The dynamics of vascular age and LV global longitudinal strain was studied in 154 patients 3 and 12 months after COVID-19 pneumonia (51 ± 12 years, 48% were women). The control group consisted of 55 sexand age-matched individuals.Results. During the follow-up, the average baPWV decreased (13.2 [11.8; 15.1] cm / sec vs. 13.0 [11.8; 14.1] cm/ s; p < 0.001), and the frequency of its elevated values declined (45.4 vs. 35.1%; p = 0.008). The average ABI increased (1.09 [1.04; 1.14] vs. 1.11 [1.06; 1.17]; p = 0.012), but remained within the normal range. LV global longitudinal strain (LV GLS) (–19.6 ± 2.2 and –19.7 ± 2.5%; p = 0.854) and the frequency of reduced LV GLS (21.4 and 26.6%; p = 0.268) did not change significantly and did not differ from values in the control group. Global longitudinal strain in the LV basal inferoseptal segment improved (–19.2 ± 3.6% vs. –20.1 ± 4.0%; p = 0.032). The early diastolic mitral annular velocity decreased (8.4 ± 3.0 cm / s vs. 8.0 ± 2.5 cm / s; p = 0.023). The LV isovolumic relaxation time was greater than in the control group (101.8 ± 22.3 ms at the 1st visit vs. 92.9 ± 21.5 ms; p = 0.012; 105.9 ± 21.9 ms vs. 92.9 ± 21.5 ms at the 2nd visit; p < 0.001). A positive correlation was found between baPWV (r = 0.209; p = 0.009) and ABI (r = 0.190; p = 0.021) and strain parameters of the LV basal segments 12 months after discharge.Conclusion. Patients with optimal visualization on echocardiography at 12 months after COVID-19 pneumonia, compared to the results of the examination 3 months after the disease, had deteriorated parameters of LV diastolic function. LV GLS was within the grey zone and did not change significantly. An improvement in arterial stiffness was noted, associated with an improvement in the strain of basal LV segments.

Background — The significance of cytokine activation and immune inflammation in subclinical damage to cardiomyocytes and resulting development of the congestive heart failure (CHF) is frequently discussed in published studies, as well as whether there are cardiac lesions in COVID-19 survivors identified by the speckle tracking echocardiography (STE). Objective — To examine the association of echocardiographic parameters with indications of immune inflammation in patients recovered from COVID-19 pneumonia depending on segmental longitudinal strain (LS) of the left ventricle (LV) identified by STE. Methods — Our study encompassed 216 patients (51.1% men, mean age of 50.1±11.1 years) distributed among two groups: Group I (n=108) included study subjects with segmental LS (≥3 LV segments) revealed by the STE; Group II (n=108) comprised patients without visually detectable LV lesions. All patients were examined three months after COVID-19 pneumonia. Results — Groups did not differ statistically significantly in terms of LV ejection fraction (68.7±4.3% in Group I vs. 68.6±4.3% in Group II; p=0.916). Global LS was significantly lower in the Group I than in the Group II at the time of the control follow-up visit three months later (-18.2 [-16.7; -19.4] % vs. -20.6 [-19.5; -22.1] %, respectively; p<0.001). When analyzing laboratory indications of immune inflammation in groups, we revealed statistically significantly higher values in Group I vs. Group II in the concentrations of interleukin 6 (3.1 [2.4;3.9] pg/mL vs. 2.5 [3.8;4.7] pg/mL; p=0.009), C-reactive protein (4.7 [2.9;8.3] mg/L vs. 3.0 [1.5; 5.3] mg/L; p<0.001), and tumor necrosis factor α (6.0 [4.8;4.1] pg/ml vs. 5.0 [4.0;6.4] pg/ml; p=0.001). In Group I, we detected diffuse lesion of LS (≥4 segments of the same LV level; 38.0% of patients) and regional lesion of LS (≥3 segments corresponding to the blood supply pools of the anterior, circumflex, or right coronary arteries; 62.0% of patients). According to logistic regression, the LS of the basal LV level (OR 3.028; 95% CI 1.909-4.802; р<0.001) in combination with LS of the apical LV level (OR 1.287; 95% CI 1.099-1.507; р=0.002) and LV lateral wall annular velocity assessed by tissue Doppler imaging, peak e’ (OR 0.774; 95% CI 0.657-0.911; р=0.002) had an independent relationship with each of diffuse and regional LS lesions. Conclusion — Based on STE data, we have identified a relationship of diffuse and regional LV lesions with features of systolic and diastolic LV dysfunction and markers of immune inflammation in patients three months after COVID-19 pneumonia.

Цель. Изучить динамику и взаимосвязи клинических данных и эхокардиографических (ЭхоКГ) показателей функции миокарда больных сердечно-сосудистыми заболеваниями (ССЗ) с оптимальной визуализацией через 3, 12 и 26 мес после пневмонии COVID-19.

Aim To identify predictors of decreased left ventricular global longitudinal strain (LV GLS) using the method of speckle-tracking in gray scale one year after COVID-19-associated pneumonia in patients without ischemic heart disease (IHD), previous pulmonary embolism (PE), peripheral thrombosis, and atrial fibrillation (AF). Material and methods The study included 156 patients from the Prospective Registry of People After COVID-19-Associated Pneumonia, with optimal visualization quality according to echocardiography (EchoCG), without IHD, AF, history of pulmonary embolism (PE), and peripheral thrombosis. The patients underwent clinical examination in the hospital during the acute period and at 3 and 12 months after discharge from the hospital. To identify earlier predictors of LV GLS impairment, clinical, laboratory, and instrumental data obtained in the hospital and at 3 months of discharge were compared based on the presence of LV GLS impairment one year after discharge (43 patients with reduced LV GLS and 113 patients with normal LV GLS). An LV GLS value ≥18% was considered reduced. Results At 3 months after discharge from the hospital, LV GLS impairment was detected in 34 (21.8%) of 156 patients, and 12 months later, in 43 (27.6%; p=0.211) of 156 patients. In contrast to the group with normal LV GLS, the majority of the group with reduced LV GLS were men (74.4% vs. 37.2%; p=0.001). In this group, body mass index (BMI) was significantly higher (29.9±4.3 kg/m2 vs. 28.1±4.5 kg/m2; p=0.011), and biological (11.6% vs. 2.7%; p=0.024) and hormonal therapy was administered more frequently (38.1% vs. 22.3%; p=0.049). The final predictive model for LV GLS impairment included male gender (odds ratio (OR), 5.65; 95% confidence interval (CI), 1.22-14.37; p <0.001), BMI (OR, 1.11; 95% CI, 1.01-1.23; p=0.040), left ventricular end-systolic volume index (LVESVI) (OR, 1.10; 95% CI, 1.01-1.22; p=0.046) and right ventricular outflow tract (RVOT) acceleration time (OR, 0.98; 95% CI, 0.95-0.99; p=0.027). Conclusion One year after COVID-19-associated pneumonia, a decrease in LV GLS was observed in 27.6% of patients without IHD, AF, history of PE, and peripheral thrombosis and was associated with male gender, increased BMI and LVESVI, and shortened RVOT acceleration time as measured 3 months after discharge from the hospital. The decrease in LV GLS one year after discharge was not associated with the severity of the disease, length of stay in the hospital, or biological and hormonal therapy.

Aim: To evaluate clinical and morpho-functional predictors of super-response to cardiac resynchronization therapy (CRT) in patients with heart failure and reduced ejection fraction (HFrEF) in the short-term period after implantation. Material and Methods. The study enrolled 86 patients (88.4% men, 54.0 ± 8.9 years mean age, New York Heart Association (NYHA) class II–IV). Patients were examined at baseline and in dynamics (mean follow-up was 10.6 ± 3.6 months). According to the change in left ventricular (LV) end-systolic volume (ESV) patients were divided into two groups: Group I ( n = 19) with a decrease in LV ESV ≥ 30% (super-responders (SR) and Group II ( n = 67) – decrease in LV ESV < 30% (non-super-responders (non-SR). Parameters of mechanical dyssynchrony (MD) were assessed in the two groups including LV pre-ejection period, interventricular mechanical delay (IVMD), intraventricular delay (IVD). Results. At baseline, traditional parameters of MD were higher in SR: LV pre-ejection period (156.8 ± 35.4 ms vs 135.0 ± 35.6 ms; p = 0.021) and IVMD (73.0 [43.0; 108.0] ms vs 47.0 [19.5; 70.0] ms; p = 0.017). Logistic regression results showed that female gender (HR 7.048; 95% CI 1.496–33.206; p = 0.014) and QRS width (HR 1.017; 95% CI 1.000–1.034; p = 0.048) had an independent association with super-response. Conclusion. In patients with HFrEF, more severe mechanical and electrical dyssynchrony is associated with super-response to CRT in a short-term follow-up period.

Background. Studying the impact of complicated course of new coronavirus infection on the cardiovascular system in the long term after patient discharge from hospital is of high significance. Purpose. To compare the clinical and echocardiographic parameters of persons with history of verified COVID-19 pneumonia one year after discharge from hospital depending on the value of left ventricular (LV) global longitudinal strain (GLS). Material and Methods. A total of 116 patients (50.4% men) aged 49.0 ± 14.4 years (from 19 to 84 years) with history of verified COVID-19 pneumonia were examined one year ± three weeks after discharge. The parameters of left ventricular global and segmental longitudinal strain were studied in 80 patients with optimal quality of echocardiographic visualization. Patients were divided into groups depending on the LV GLS value: group 1 included 35 patients with normal LV GLS (<–20%); group 2 comprised 45 patients with impaired LV GLS (≥–20%). The groups did not differ in age ( p = 0.145), severity of lung injury during hospitalization ( p = 0.691), duration of hospitalization ( p = 0.626), and frequency of stay in the intensive care unit ( p = 0.420). Results. Abnormal values of LV GLS one year after discharge were found in 57.5% of patients with optimal visualization quality while the LV ejection fraction (EF) was normal in all patients. The majority of patients in group 2 were men (71.1% vs 28.6%, p < 0.001). A combination of coronary artery disease (CAD) and hypertension (AH) was more often diagnosed in this group (22% vs 6%, p = 0.040). The values of LV EF did not differ between the groups. The values of LV GLS were significantly worse in patients of group 2 (–17.6 ± 1.9% vs –21.8 ± 1.2%, p < 0.001). Moreover, the parameters of diastolic function including the left atrial emptying volume index (1.3 ± 0.3 mL/m2 vs 1.4 ± 0.3 mL/m2, р = 0.052) and velocity of the lateral part of the mitral valve fibrous ring e’ (10.8 ± 4 .4 cm/s vs 12.8 ± 4.0 cm/s, p = 0.045) were also lower in this group. Conclusions. The LV GLS was impaired in 57.5% patients with normal LV EF one year after COVID-19 pneumonia. In the group with impaired LV GLS, men predominated; coronary artery disease was more often detected in combination with AH; and parameters of LV diastolic function were worse compared with the corresponding parameters in the group of patients with normal LV GLS.

Aim. To study the changes of clinical and echocardiographic parameters in people without cardiovascular diseases (CVDs) within a year after coronavirus disease 2019 (COVID-19) depending on the obesity presence. Material and methods. During the year after COVID-19 pneumonia, the clinical and echocardiographic parameters of 21 patients with obesity and without CVD were compared. The group both without CVDs and obesity consisted of 52 patients comparable by sex and age. Results. Newly developed CVDs were registered in 55% and 17% of the group with and without obesity, respectively. Left ventricular (LV) global longitudinal strain 3 months (-18,4±2,3 vs -20,6±2,2%, p=0,010) and one year after COVID-19 pneumonia (-18,8±1,8 vs -20,8±2,5%, p=0,021) was lower in the group with obesity. Lateral (e' later) (10,8±3,3 vs 13,1±2,9 cm/s (p=0,007)) and septal (e' sept) (8,5±2,7 vs 10,1±2,0 cm/s (p=0,011)) early diastolic mitral annulus velocity, as well as the ratio of early and late diastolic LV filling (E/A) (1,1±0,3 vs 1,2±0,3 (p=0,019)) at the end of the follow-up were lower in the group with obesity. Conclusion. In people without CVDs during a year after COVID-19 pneumonia, a high prevalence of newly developed CVD was noted in 55% and in 17% of people with and without obesity, which was accompanied by worse LV systolic and diastolic function in the group with obesity.

Цель. Изучить динамику сердечно-сосудистой патологии, параметров продольной деформации и диастолической функции левого желудочка (LV GLS) через 3 и 12 мес после пневмонии COVID-19.

Objective: evaluation of gender differences in the antihypertensive effect after denervation of the renal arteries based on the results of office and daily measurements of blood pressure in resistant arterial hypertension in a 3-year follow-up. Materials and methods : the study involved 80 patients with resistant arterial hypertension (RAH); Patients were divided by stratification randomization into the interventional treatment group, who continue to receive antihypertensive therapy (AHT) (RDN group) and the MT group (patients on drug therapy only. The study groups were comparable in terms of gender, age, duration of hypertension, the number of antihypertensive drugs taken, the presence of For 12 months, a comparative study was conducted between groups, further analysis of the effectiveness of surgical treatment of RDN PA was carried out at control points of 24 and 36 months, in which laboratory and instrumental examinations were performed. Results : according to the office measurement of blood pressure within the RDN and MT study groups, both in men and women, it turned out to be similar. After 12 months of observation between the comparison groups, the women of the group showed a statistically significant negative dynamics of the office SBP (p<0.01) and office DBP (p<0.05) parameters. According to the analysis of average daily, average daily, average night SBP indicators, after 12 months in the RDN group, a decrease was observed in all main parameters (p<0.001). It is worth paying attention to the fact that in the MT group, among the average daily, average daily, average night ABPM indicators after 12 months, no statistically significant changes were detected. When conducting a gender analysis of ABPM indicators using the Friedman test and correcting the p value for multiple comparisons at visits of 24 and 36 months, a statistically significant decrease in the main average daily indicators in women was demonstrated, while in men such changes were not established. Conclusions : the data obtained indicate a more pronounced antihypertensive effect after radiofrequency denervation of the renal arteries in resistant arterial hypertension in women.

Among various diagnostic methods, echocardiography (EchoCG) is most often used to identify Takotsubo syndrome. Left ventricular apical ballooning and the absence of permanent local contractility disturbances makes it possible to confirm the diagnosis. Currently, the available literature provides insufficient data on longitudinal strain (LS) of various cardiac chambers in this condition. The current case report demonstrates complete restoration of left heart LS within 1 month with its initial significant decrease.

Aim. To study the changes of morphological and functional right ventricular (RV) parameters depending on the severity of coronavirus infection 2019 (COVID-19) pneumonia over long-term follow-up.Material and methods. A total of 200 patients (men, 51,5%, mean age, 51,4±10,9 years) were examined at 2 control visits (3, 12 months after receiving two negative polymerase chain reaction tests). Patients were divided into following groups: group I (n=94) — lung tissue involvement ≥50% according to inhospital chest computed tomography (chest CT), group II (n=106) — lung tissue involvement˂50% according to chest CT.Results. The groups were comparable in key clinical and functional parameters 3 months after COVID-19 pneumonia. Speckle tracking echocardiography (STE) revealed a significant increase in following global longitudinal strain (LS) parameters: RV free wall endocardial LS (-22,7±3,2% and -24,3±3,8% in group I, p<0,001; -23,2±3,5% and -24,5±3,4% in group II, p><0,001), and RV endocardial LS (-21,0±3,1% and -22,5±3,7% in group I, p><0,001, -21,5±3,2% and -22,6±3,3% in group II, p=0,001 ). Significant increase of segmental endocardial LS was revealed in group I in the basal segments of RV free wall (-26,2±5,1% and -28,1±5,1%, p=0,004) and interventricular septum (IVS) (-16,2 [13,9; 19,5]% and -17,5 [14,6; 21,4]%, p=0,024), IVS middle segment (-20,3±4,1% and -21,5±4,8%, p=0,030), as well as in group II in the apical segments of RV free wall (-21,9±6,7% and -24,4±5,2%, p=0,001) and IVS (-23,7±4,7% and -24,9±4,8%, p=0,014). Conclusion. Recovery of RV function during a 12-month follow-up period in patients with both severe and moderate/mild lung involvement in COVID-19 was detected using the STE method.>˂0,001; -23,2±3,5% and -24,5±3,4% in group II, p˂0,001), and RV endocardial LS (-21,0±3,1% and -22,5±3,7% in group I, p˂0,001, -21,5±3,2% and -22,6±3,3% in group II, p=0,001 ). Significant increase of segmental endocardial LS was revealed in group I in the basal segments of RV free wall (-26,2±5,1% and -28,1±5,1%, p=0,004) and interventricular septum (IVS) (-16,2 [13,9; 19,5]% and -17,5 [14,6; 21,4]%, p=0,024), IVS middle segment (-20,3±4,1% and -21,5±4,8%, p=0,030), as well as in group II in the apical segments of RV free wall (-21,9±6,7% and -24,4±5,2%, p=0,001) and IVS (-23,7±4,7% and -24,9±4,8%, p=0,014).Conclusion. Recovery of RV function during a 12-month follow-up period in patients with both severe and moderate/mild lung involvement in COVID-19 was detected using the STE method.

Purpose: To study the prevalence of cardiovascular diseases and the correlations of left ventricle global longitudinal strain (LV GLS) in patients 3 months after proven COVID-19 pneumonia. Material and methods. 369 patients with proven COVID-19 pneumonia underwent a comprehensive clinical examination and echocardiography (EchoCG) after 3 months ± 3 weeks after their discharge from the hospital. Mean age of the patients was 54 [46; 61]; 50.9% of them were women. LV GLS was studied in 284 (77%) of patients with optimal visualization quality during echocardiography. LV GLS was considered reduced in the limit of > –18%. Study Registration: ClinicalTrials.gov ID: NCT04501822. Results. 3 months after discharge, obesity was noted in 46.5% of patients, cardiovascular diseases were diagnosed in 73.4%, including de novo in 8.4%. Arterial hypertension occurred in 71.5% of patients, coronary artery disease — in 22.5%. The average left ventricle (LV) ejection fraction was 67.8 ± 5.0%, the average LV GLS was –19.5 ± 2.3%. LV GLS was reduced in 24.4% of the patients. LV GLS showed no correlation with the patient age, NYHA functional class and LV ejection fraction. Reduced LV GLS was independently associated with male sex (OR 1.399; 95% CI 1.239–1.580; p < 0.001), obesity (OR 1.268; 95% CI 1.132–1.421; p < 0.0001), diabetes mellitus (OR 1.204; 95 % CI 1.017–1.425; p = 0.031) and hypertension (OR 1.120; 95% CI 1.002–1.252; p = 0.046). LV GLS showed moderate positive correlations with echocardiographic parameters of right ventricle (RV): the length (r = 0.346), diastolic (r = 0.333) and systolic area (r = 0.326), width at the basal (r = 0.358) and midlevel (r = 0.321), as well as with the dimension of the proximal RV outfl ow tract (r = 0.302, all p < 0.001). LV GLS showed a weak correlation with the severity of lung lesions during hospitalization (r = 0.184; p = 0.002). Conclusions. 3 months after COVID-19 pneumonia, cardiovascular diseases were diagnosed in 73.4%. Reduced LV GLS was observed in 24.4% of survivors and was associated with male sex, obesity, diabetes mellitus, arterial hypertension and linear and planimetric RV dimensions.

Aim. To study the changes of biventricular contractile function depending on the types of left ventricular involvement according to the speckle tracking echocardiography (STE).Material and methods. Of the 380 patients from the Prospective Registry of People Survived COVID-19 Pneumonia, the study included 85 patients, which can be followed-up — 3 months (visit 1) and 12 months (visit 2) after COVID-19 pneumonia (men — 68,2%; mean age — 50,6±10,9 years).At visit 2, patients with diffuse left ventricle (LV) involvement according to STE (visual involvement of ≥4 segments of the same LV level) comprised group I (n=27), patients with regional LV involvement (≥3 segments corresponding to anterior, circumflex or right coronary arteries) — group II (n=39), patients without visual LV involvement — group III (n=19).Results. The groups were comparable in main clinical, functional and echocardiographic (conventional) parameters 3 and 12 months after COVID-19 pneumonia, with the exception of sex and body mass index. STE in group I showed a significant decrease in global longitudinal strain (GLS) (-18,0±2,0% at visit 1 and -16,9±1,4% at visit 2, p=0,025) and LS of all LV levels; in group II — an increase in right ventricular free wall strain (RV FWS) (-22,8±3,2% and -24,0±2,6%, respectively, p=0,006); in group III — an increase in GLS (-19,3±2,3% and -21,2±1,9%, p=0,005), LS of basal and medium LV levels, RV FWS (-23,3±2,9% and -25,0±3,0%, p=0,033). In group I, a significant increase in affected LV segments was revealed (7,0 [5,0;9,0] and 9,0 [7,0;10,0], p=0,010), while in group III there was a decrease in their number (5,0 [3,0;6,0] and 10,0 [1,0;2,0], p<0,001). According to logistic regression, LV basal LS at visit 1 (odds ratio 0,420; 95% confidence interval 0,273-0,644; p<0,001) had an independent association with diffuse LV involvement at visit 2. When it decreases, <15,8% sensitivity and the specificity of this model in predicting diffuse LV involvement was 74,1% and 74,1%, respectively (AUC=0,807; p<0,001).Conclusion. Patients with diffuse LV involvement according to STE are characterized by suppression of global biventricular contractile function during 1-year follow-up.

Aim . To investigate the relationship between echocardiographic parameters and laboratory immune inflammation signs in patients after coronavirus disease 2019 (COVID-19) pneumonia depending on the left ventricular (LV) involvement according to speckle tracking echocardiography (STE). Material and methods . The study included 216 patients (men, 51,1%, mean age, 50,1±11,1 years). The examination was carried out in patients 3 months after COVID-19 pneumonia. Patients were divided in 3 groups: group I (n=41) — diffuse decrease (≥4 segments the same LV level) of longitudinal strain (LS) according to STE; group II (n=67) — patients with regional decrease (LS reduction ≥3 segments corresponding to systems of the anterior, circumflex or right coronary arteries); group III — patients without visual left ventricle involvement (n=108). Results . There were no significant differences in LV ejection fraction — 68,9±4,1% in group I, 68,5±4,4% in group II and 68,6±4,3 in group III (p=0,934). A decrease in the global longitudinal left ventricle strain was detected significantly more often in groups I and II compared with group III (-17,8±2,0, -18,5±2,0 and -20,8±1,8%, respectively; p<0,001). At the same time, LS depression of LV basal level (-14,9±1,5, -16,8±1,2% and -19,1±1,7%; p<0,001), as well as a decrease in LS of LV inferior-posterior segments in group with diffuse involvement was detected significantly more often than in groups II and III. In addition, we revealed a significant difference in interleukin-6 concentration — 3,1 [2,5;4,0], 3,1 [2,4;3,8] and 2,5 [3,8;1,7] pg/ml, (p=0,033), C-reactive protein — 4,0 [2,2;7,9], 5,7 [3,2;7,9] and 2,4 [1,1;4,7] mg/l, (p<0,001), tumor necrosis factor-a — 5,9±1,9, 6,2±1,9 and 5,2±2,0 pg/ml, (p=0,004) and ferritin — 130,7 [56,5;220,0], 92,2 [26,0;129,4] and 51,0 [23,2;158,9] pg/l, respectively (p=0,025). Conclusion . A relationship was found between diffuse and regional left ventricular involvement according to STE and signs of immune inflammation in patients 3 months after COVID-19 pneumonia.

Low-grade systemic inflammation, myocardial stress, and extracellular matrix fibrosis lead to heart failure with preserved ejection fraction (HFpEF). The HFA-PEFF diagnostic algorithm and the H2FPEF score are recommended for detecting HFpEF. Their low compliance is the reason for improving the methods for diagnosing HFpEF. Modern paraclinical diagnostics of HFpEF includes an assessment of the left ventricular filling pressure during diastolic stress test. Phase analysis of left atrial strain during resting echocardiography may be promising to conclude an increase in mean left atrial pressure. Research interest is growing in relation to biomarkers involved in the regulation of collagen synthesis. Together, paraclinical diagnostics help to characterize sequential morphofunctional cardiac remodeling, increasing the possibility of HFpEF detection.