LABORATORY DIAGNOSTICS OF EARLY HEART FAILURE

Many diseases of the cardiovascular system require precisely timely diagnosis to prevent acute and chronic pathological processes and complications. The article presents laboratory indicators and markers, the use of which helps a modern physician to diagnose correctly and timely, predict the onset of illness in patients and monitor the treatment of a diagnosis such as heart failure. Confirmation of CH and/or cardiac dysfunction by echocardiography is mandatory and should be carried out as soon as possible after suspected CH. Electrocardiographic examination (ECG) should be performed for each patient with suspected CH. If ECG is completely normal, CH, especially systolic dysfunction, is unlikely (<10%). X-ray examination of the chest organs is a necessary component in diagnostic CH search. It allows you to assess pulmonary stagnation or to show important pulmonary or thoracic causes of shortness of breath. Patients in whom resting echocardiography does not provide adequate information and in patients with suspected CHD, a further non-invasive study may include a magnetic resonance imaging (MRD) of the heart, CT (CT) of the heart, or radionuclide ventriculography. There is evidence to support the effectiveness of using natriuretic peptides for diagnosis, addressing the issue of hospitalization / discharge and the definition of individual prognosis, and there is a lack of evidence of their use for surveillance and regulation of drug therapy. The response of healthy heart tissue to damage or mechanical stress in-cludes the production and binding of interleukin-33 (IL-33) to ST2L by launching a cardioprotective signalling phase for the prevention of fibrosis, heart remodelling and heart failure (CH). sST2 blocks the cardioprotective effect of IL-33. Determination of ST2 at discharge can significantly reduce cases of rhizospitalization within 30 days. The level of BNP at ST2> 35 ng / ml is both elevated and normal, which may mislead physicians. Often in clinical practice, doctors meet such concepts as "false-negative" and "false-positive" result, qualitative or semi-quantitative false result. This happens first through the right selection of the method of determining one or another marker. For example, in order to monitor the management of acute myocardial infarction, it is only necessary to determine the level of troponin quantitatively, since only in this case it will be seen how its numerical parameters change at the stages of treatment. Since ST2 does not depend on factors such as BMI, gender, age, smoking status, and the presence of concomitant pathologies, it may be one of the "strongest" predictive markers of CH. The introduction of ST2 into routine practice will significantly reduce hospital costs (reducing the number of repeated hospitalizations, eliminating unnecessary drugs, etc.) and improving the quality of life of patients with CH (to reduce the rate of progression of CH). Based on the above, it can be accurately said that the earliest diagnostic marker of heart failure is a marker - ST2.