E.G. AKRAMOVA^{1, 2, 3, A.F. AKHATOV3}

 ¹Municipal Clinical Hospital No. 18, 2 Mavlyutov Str., Kazan, Russian Federation, 420101

² KSMA ― Branch Campus of the FSBEI FPE RMACPE MOH Russia , 36 Butlerov Str., Kazan, Russian Federation, 420012

³BARSMED Ltd Diagnostic Center, 2 Mavlyutov Str., Kazan, Russian Federation, 420101 

Akramova E.G. ― D. Med. Sc., Associate Professor of the Department of Ultrasound Diagnostics, Head of the Department of Functional Diagnostics, tel. +7-905-024-14-80, e-mail: akendge@rambler.ru

Akhatov A.F. ― Chief Doctor, tel. +7-905-024-14-80, e-mail: aya0258@googlemail.com

We have compared the clinical significance of various technologies of echocardiographic examination of patients with community-acquired pneumonia while diagnosing the structural and functional cardiac abnormalities. We examined 54 patients with moderate and severe community-acquired pneumonia, confirmed by multislice computer tomography of lungs, and 24 practically healthy persons of 19-59 y.o. Two- and three-dimensional echocardiography was carried out, using techniques of speckle tracking and tissue Doppler. The use of tissue Doppler improves the detection of ventricular diastolic dysfunction from 7 to 26 %; speckle tracking improves the detection of systolic dysfunction from 6 to 76 %. In the early days of severe pneumonia in 27.3 % of patients ultrasound signs of parapneumonic perimiocarditis were recorded: reduction of left ventricular ejection fraction to the lower limit of the norm, small pericardial effusion, diastolic dysfunction of both ventricles of pseudonormal type and reduction of global longitudinal systolic strain according to the speckle tracking technology.

Key words: echocardiography, tissue Doppler, three-dimensional echocardiography, speckle-tracking echocardiography, community-acquired pneumonia.

REFERENCES

1. Kurenkova I.G., Yakovlev V.A. Features of hemodynamic disorders and possible mechanisms of acute pulmonary heart formation in patients with community-acquired pneumonia. Vestnik Rossiyskoy voenno-meditsinskoy akademii, 2012, no. 1, pp. 296-300 (in Russ.).
2. Singanayagam A., Elder D., Chalmers J. Is community-acquired pneumonia an independent risk factor for cardiovascular disease? Eur. Respir. J, 2012, no. 1, pp. 187-196.
3. Smeeth L., Thomas S.L., Hall A.J. et al.  Risk of myocardial infarction and stroke after acute infection or vaccination . N.Engl.J. Med, 2004, no. 351, pp. 2611-2618.
4. Clayton T.C., Thompson M., Meade T.W. Recent respiratory infection and risk of cardiovascular disease: case-control study through a general practice database. Eur. Heart J, 2008, no. 29, rr. 96-103.
5. Corrales-Medina V.F., Musher D.M., Wells G.A., Chirinos J.A. et al. Cardiac complications in patients with community-acquired pneumonia: incidence, timing, risk factors, and association with short-term mortality circulation. Circulation, 2012, no. 6, rr. 773-781.
6. Griffin A.T., Wiemken T.L., Arnold F.W. Risk factors for cardiovascular events in hospitalized patients with community-acquired pneumonia. Int. J. Infect. Dis, 2013, no. 12, rr. 1125-1129.
7. Prescott H.C., Sjoding M.W., Iwashyna T.J. Diagnoses of early and late readmissions after hospitalization for pneumonia. A systematic review. Ann. Am. Thorac. Soc, 2014, no. 7, rr. 1091-1100.
8. Dharmarajan K., Hsieh A.F., Kulkarni V.T. et al. Trajectories of risk after hospitalization for heart failure, acute myocardial infarction, or pneumonia: retrospective cohort study. BMJ, 2015, no. 5, pp. 350.
9. Israilova N.A. Pathomorphological characteristics of the heart of children who died of acute pneumonia. Vestnik sovremennoy klinicheskoy meditsiny, 2015, no. 5, pp. 32-35 (in Russ.).
10. Kamalov I.A., Tukhbatullin M.G. Right ventricular failure and pulmonary hypertension in relapsing thromboembolism of small branches of the pulmonary artery in patients with malignant neoplasms. Kazanskiy meditsinskiy zhurnal, 2015, no. 4, pp. 492-497 (in Russ.).
11. Chuchalin A.G. Pneumonia: an urgent problem of medicine of the XXI century. Terapevticheskiy arkhiv, 2016, no. 3, pp. 4-12 (in Russ.).
12. Nagueh S.F., Smiseth O.A., Appleton C.P. et al. Recommendations for the Evaluation of Left ventricular Diastolic dysfunction by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J. Am. Soc. Echocardiogr, 2016, no. 29, rr. 277-314.
13. Lang R.M., Badano L.P., Mor-Avi V. et al.  Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J. Am. Soc. Echocardiogr, 2015, no. 28, rr. 1-39.