The violation of local LV contractility in patients with coronary artery disease is usually described on a five-point scale: 1 point – normal contractility; 2 points – moderate hypokinesia; 3 points – severe hypokinesia; 4 points – akinesia; 5 points – dyskinesia. After assessing the nature of regional contractility, an index of local contractility is calculated, which is the sum of the scoring of the contractility of each segment divided by the total number of segments studied -n (usually 16):
HUD = S / n
Normally, the ILS values are 1 (one). High values of this indicator in patients with MI or postinfarction cardiosclerosis are often associated with an increased risk of death and the development of HF. It should be remembered that with EchoCG it is not always possible to achieve a sufficiently good visualization of all 16 segments. In these cases, only those areas of the myocardium of the LV that are well identified in a two-dimensional study are taken into account.
The main causes of local impairment of LV contractility can be: acute myocardial infarction (AMI), post-infarction cardiosclerosis, transient myocardial ischemia (including induced stress tests – stress echocardiography), permanent myocardial ischemia with the development of a “beating myocardial heart attack.” intraventricular conduction (blockade of the bundle branch block, WPW syndrome, etc.)