Perm Medical JournalPerm Medical Journal0136-14492687-1408Eco-Vector309410.17816/pmj3236-13Research ArticleCOMPLEX ASSESSMENT OF RIGHT VENTRICULAR FUNCTION IN PATIENTS WITH MULTIVASCULAR CORONARY artery LESIONSOsetrovaO Aosetrova.olya@mail.ruOrekhovaE N-1506201532361312072016Copyright © 2015, Osetrova O.A., Orekhova E.N.2015Aim. To carry out complex assessment of the right ventricular function in patients with multivascular coronary lesions. Materials and methods. Sixty three patients aged 58,5 ± 9 years including 46 men (73 %) with multivascular coronary lesions were examined. In addition to general clinical protocol of the study, the results of selective coronarography with determination of SYNTAX Score, MRI with contrast gadolinium strengthening and EchoCG with studying of tissue myocardial dopplerography and 2D-speckle tracking echocardiography were compared. Results. The signs of mechanical right ventricular myocardial dysfunction with preserved systolic function and standard right ventricular volumes by MRI data were detected. In particular, segmental deformation and deformation rate indices were changed. Manifestation of inhibited systolic dysfunction of the right ventricle depended on complexity and severity of coronary lesions: moderate invert correlation of SYNTAX Score and that of right ventricular ejection fraction by MRI data ( R s = -0,6) was observed. The higher is SYNTAX Score index, the more expressed is myocardial dysfunction (Tei index, R s = -0,4) and the lower is deformation at the level of tricuspid valve fibrous ring ( R s = -0,5). Conclusions. Tissue myocardial dopplerography and 2D-speckle tracking echocardiography included into the protocol of examining patients with multivascular coronary lesions for the purpose of assessment of the right ventricular function permits to confirm its involvement into the process of ischemic heart remodeling.Right ventricleechocardiographylongitudinal systolic deformationmagnetic resonance imagingПравый желудочекэхокардиографияпродольная систолическая деформациямагнитно-резонансная томография[Бокерия Л. А., Бусленко Н. С., Бузиашвили Ю. И. Дисфункция миокарда правого желудочка при ишемической болезни сердца (анатомия, патофизиология, диагностика, клиническое значение в кардиохирургии). М.: НЦССХ им. А.Н. Бакулева РАМН 2010; 324.][Оганов Р. Г., Мамедов М. Н. Национальные клинические рекомендации. М.: Силицея-Полиграф 2009; 512.][Шиллер Н. Б., Осипов М. А. Клиническая эхокардиография. М. 1993; 347.][Bleeker G. B., Steendijk P., Holman E. R. Assessing right ventricular function: the role of echocardiography and complementary technologies. Heart 2006; 92 (1): 119-126.][D’hooge J., Heimdal A., Jamal F. Regional strain and strain rate measurements by cardiac ultrasound: principles, implementation and limitations. Eur. J. Echocardiogr 2000; 1: 154-170.][Goldstein J. A. Pathophysiology and management of right heart ischemia. J. Am. Coll. Cardiol. 2002; 40: 841-853.][Haddad F., Hunt S. A., Rosenthal D. N. Right ventricular function in cardiovascular disease. Part I. Circulation 2008; 117: 1436-1448.][Hyun Suk Yang, Farouk Mookadam. Evalution of right ventricular global and regional function during stress echocardiography using novel velocity vector imaging. Eur. J. of Echocardiogr. 2010; 11: 157-164.][Jamal F., Bergerot C. Argaut L. Longitudinal strain quantitates regional right ventricular contractile function. Am. J. Physiol. Heart. Circ. Physiol. 2003; 285: H2842-H2847.][Kowalski M., Kukulski T., Jamal F. Can natural strain and strain rate quantify regional myocardial deformation? A study in healthy subjects. Ultrasound Med. Biol. 2001; 27: 1087-1097.][Lang R. M., Bierig M., Devereux R. B. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J. Am. Soc. Echocardiogr. 2005; 18: 1440-1463.][Roes S. D., Mollema S. A., Lamb H. J. Validation of echocardiographic two-dimensional speckle tracking longitudinal strain imaging for viability assessment in patients with chronic ischemic left ventricular dysfunction and comparison with contrast-enhanced magnetic resonance imaging. Am. J. Cardiol. 2009; 104: 312-317.][Rudski L. G., Lai W. W., Afilalo J. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography. Endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiogr. J. of the Am. Soc. Echocardiogr. 2015; 23: 685-713.][Serruys P., Morice M. C., Kappetein A. P. Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. N. Engl. J. Med. 2009; 360: 961-972.]