Trembovets'ka O. Speckle-tracking echocardiography diagnostics of morphofunctional features of the normal left ventricular myocardium and in different variants of intracardiac hemodynamics impairment.

The paper presents the analysis of observation of 307 individuals (54 healthy volunteers and 253 patients with multiple lesions of left ventricle of heart), who were examined at GF "M. Amosov National Institute of Cardio-Vascular Surgery NAMS of Ukraine". The thesis provides new data with regard to the features of the path of systolic and diastolic motion of each LV segment; morphofunctional relationships, supporting the motion in normal condition, as well as in primary myocardium pathology in patients with hypertrophic cardiomyopathy and dilated cardiomyopathy and in myocardium impairments, caused by LV overload by the volume and pressure, have been defined. For the first time the author obtained new data relative to structure of normal myocardium, i.e.: anterior aorto-trabecular muscle bundle, promoting longitudinal displacement of the basal segments during the systole and blood ejection from the LV into aorta was detected; vertical posterobasal muscular band, ensuring the rotation of basal segments was detected. The new principle of myocardium structure has been proposed, according to which the motion path of each section of LV wall depends on both the direction of compact myocardium muscle fibers and supporting structures. The paper shows for the first time that the basal form of hypertrophic cardiomyopathy is based on cardiac hystiocyte aorto-trabecular muscle bundle displacement to the direction of interventricular septum, followed by changes in contraction sequence: basal segments, in contrast to normal condition, are contracted earlier than apical ones. For the first time the author obtained data, explaining the acute augmenting of cardiac weakness signs in occurrence of left bundle-branch block due to absence of torsion component of LV compound motion path as a result of redirection of apical segments' rotation.