Krakhmalova O. Clinical, functional and morphological features of cardiovascular system in patients with acute pulmonary embolism and with chronic thromboembolic pulmonary hypertension.

Object of the study: Pulmonary thromboembolism, chronic postembolic pulmonary hypertension. Purpose of the study: To work out a new concept of diagnosis of pulmonary thromboembolism and chronic postembolic pulmonary hypertension based on the original methods of monitoring and evaluation of structural-functional and morphological disorders in the right ventricle, venous circulation in PTE and CPPH, determining precursors and differential diagnostic criteria of CPPH. Methods of the study: Clinical, instrumental, biochemical, morphological. Practical significance of the obtained results: Introduction of a new method of qualitative evaluation of the volume and contractile right-ventricle function to the clinical practice will allow to improve the quality of PTE and CPPH differential diagnosis, monitor the state of hemodynamics and investigate the treatment efficacy. The use of the method of automatic computed screening diagnosis promotes early diagnosis of various forms of PTE. US classification of the terms of venous thrombosis allows to investigate the state of venous flow and predict the probability of thromboembolic complications. Analysis of the heart rhythm variability in PTE allows to predict fatal impairments of the heart rhythm. The developed diagnostic algorithm allows optimizing the tactics of dynamic observation of the patients with PTE, to choose the necessary volume of instrumental and laboratory investigations, to assess correctly the obtained findings, to perform differential diagnosis of various types of pulmonary hypertension. Novelty of the obtained results: A mathematical model of the heart was proposed. The capabilities of EchoCG in determining the volume and contractile function of the right ventricle in patients with PTE and CPPH using the mathematical model were investigated. Correlation between EchoCG findings and degree of PH severity was revealed. The most significant EchoCG criteria were distinguished. An automatic method of PTE screening diagnosis was worked out. A new criterion of diagnosis of contractile function impairment in PTE and CPPH was worked out. The peculiarities of the RV remodeling and the state of hemodynamics in PTE and CPPH against a background of therapeutic measures were investigated. US criteria of venous thrombosis classification were established. US classification of venous thrombosis was worked out. Pre-cursors of CPPH risk were determined. The peculiarities of clinical signs and hemodynamic indices in patients with CPPH and PH due to COPD were compared. Differential diagnosis criteria of CPPH were de-termined. Degree of introduction: The findings of the research were introduced into the work of clinical and functional departments of Institute of Therapy (AMSU), Institute of General and Urgent Surgery (AMSU), department of ultrasound diagnosis of Institute of Cardiovascular Surgery (AMSU), laboratory of pathophysiology of Institute of Spine and Joint Pathology (AMSU), department of functional diagnosis of Institute of Children's Health Protection (AMSU), department of ultrasound diagnosis of Kharkiv City Clinical Hospital No. 4, departments of ultrasound diagnosis of Vinnitsa, Chernigiv, Dnipropetrovsk Regional Clinical Hospitals. Sphere of application: Medicine, cardiology.