Galdina I. Clinical and echocardiographic criteria for heart failure diagnosis in infants

Object of the research: infants with heart failure. Purpose of research: to improve the diagnosis and evaluation of the degree of severity of heart failure in infants. Methods of research: clinical, instrumental (electrocardiography, echocardiography, Doppler ultrasound,chest x-ray), laboratory (study of acid-base state, gas composition of the arterial and venosus blood, evaluation of oxygen budget of the organism),statistical. Practical significance of the obtained findings: ultrasound criteria for diagnosis of variants of heart failure as well as echocardiography parameters for evaluation of the degree of severity of heart failure in infants were determined. The use of the ratio IOF/ICO2 as an additional criterion of evaluation of the degree of severity of heart failure was substantiated and tested. A working classification of heart failure was suggested for infants, it allows to evaluate objectively the degree of severity of hemodynamic disorders during the observation, to determine the tactics of treatment and to control it. Novelty of the obtained findings: for the first time, echocardiography criteria for diagnosis of the type and evaluation the degree of severity of heart failure in infants of life were found. For the first time, the role of systolic and diastolic dys-function of the left ventricle in forming cardiac pathology was studied in children aged 1 month to 3 years with congenital heart disease. The association of the type of diastolic dysfunction of the left ventricle myocardium and the degree of severity of diastolic type of heart failure was determined. The features of provision of oxygen budget in infants with congenital heart diseases were studied. They consist in the fact that oxygen budget of the organism is provided by increase of tissue extraction of oxygen at low index of oxygen flow and decreased IOF/ICO2 ratio. It was proved that IOF/ICO2 can be used as an additional criterion of evaluation of the degree of heart failure severity in infants. A noves approach was substantiated toclassification of heart in infants and it's working version proposed. Degree of introduction: the findings of the research were introduced into the work of intensive care unit of Kharkiv Regional Children's Hospital, out-patient hospitals № 2, 13, 23 (Kharkiv), Krasnograd, Chuguiv Central District Hospitals. Main theoretical and practical theses of the work are used in the teaching process at pediatrics department of Kharkiv State Medical University. Sphere of application: medicine, pediatrics