CARDIOHEPATIC SYNDROME: INNOVATIVE DIAGNOSTICS BY ULTRASOUND ELASTOGRAPHY

Abstract

The purpose of this work is to study the aspects of cardiohepatic syndrome at the present stage of medicine development, as well as the diagnostic opportunities of ultrasound elastography in its assessment. The methods of statistical analysis, generalization, comparison and systematization of data were used. The article describes in detail the current state of cardiohepatic syndrome problem. To date, the cardiohepatic syndrome, along with the well-studied cardiorenal one, is becoming more and more relevant, as it reflects the hepatotrophic effect of pathogenetic chronic heart failure factors on the liver tissue. The cardiohepatic syndrome in a broad sense is the presence of simultaneous liver and heart dysfunctions in the development of various nosologies. However, most often this symptom complex is described in the literature in a narrower sense – as a consequence of organ damage to the liver due to the development of acute and chronic heart failure. The main pathogenetic mechanism of cardiac hepatopathies is liver fibrosis. The prognosis of the disease and the life of patients depends on liver fibrosis advance. And early diagnosis of pre-existing fibrosis will make it possible to suspend the process of fibrotic scarring that has begun and its further transformation into cardiac liver cirrhosis. To date, the "gold standard" of fibrosis instrumental diagnosis is a liver biopsy, but due to restrictions and contraindications, the method is limited in its use. Ultrasound elastography is the main non-invasive method for diagnosing fibrosis. At the present stage of expanded diagnostic opportunities, several methods of ultrasonic elastography are described: strain elastography, point shear wave elastography (ARFI-elastometry), indirect transient elastography, two-dimensional shear wave elastography. The experience of using ultrasound elastography is described in the diagnosis of diffuse liver diseases – hepatitises, non-alcoholic fatty liver disease. As part of the cardiohepatic syndrome studying, the technique is innovative and requires further study.