A.I. BURNASYAN FMBC CLINICAL BULLETIN

ISSN 2782-6430 (print)

State Research Center −Burnasyan Federal Medical Biophysical
Center of Federal Medical Biological Agency

The journal is published in Russian.
Format – A4.
The periodicity of the journal is 4 times a year.

Issue №2, 2026

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A.I. Burnasyan  FMBC clinical bulletin. 2026 № 2

D.A. Andreev, А.А. Kish, S.M. Razinkin

 Methodological Approaches to Early Diagnostics of Hidden Heart Dysfunction

International Office, State Research Center – Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency, Moscow, Russiа

Contact person:Kish Anna Andreevna: akish@yandex.ru

 

Abstract
Objective: Occult cardiac dysfunction is a preclinical stage of myocardial remodeling in which symptoms are absent or nonspecific, left ventricular ejection fraction may remain preserved, while more sensitive mechanical, diastolic, tissue and biomarker signals already indicate impaired cardiac reserve. The aim of this paper was to provide an IMRAD-oriented review and comparative assessment of current methods for early detection of occult cardiac dysfunction in apparently healthy individuals and in patients with somatic disease, and to define the role of the author’s expanded exercise echocardiography protocol within a contemporary diagnostic model.
Material and methods: the evidence base included clinically relevant publications from January 2021 to February 2026 and the author’s diagnostic materials obtained in athletes, athletes with overtraining syndrome, individuals with chronic psychoemotional stress, and Arctic shift workers.
Results. No single marker was sufficient across phenotypes. In individuals without established somatic disease but exposed to high professional or sports load, the most sensitive tools were left ventricular global longitudinal strain, standardized exercise echocardiography, and multichamber assessment of right ventricular, atrial and diastolic reserve. In hypertension, type 2 diabetes, obesity, cardio-oncology and related somatic settings, the highest value was achieved by combining GLS, algorithmic diastolic assessment, natriuretic peptides, high-sensitivity troponins and cardiac magnetic resonance with T1/ECV mapping and feature tracking. The author’s method identifies occult dysfunction even when biomarkers and ejection fraction remain normal by analyzing reserve responses to submaximal aerobic load. A phenotype-oriented multimodal strategy appears to be the most rational approach for timely identification and prevention of progression.

Keywords: occult cardiac dysfunction; pre-heart failure; global longitudinal strain; exercise echocardiography; cardiac magnetic resonance; NT-proBNP; right ventricular reserve; atrial function

For citation: Andreev DA, Kish АА, Razinkin SM. Methodological Approaches to Early Diagnostics of Hidden Heart Dysfunctionn. A.I. Burnasyan Federal Medical Biophysical Center Clinical Bulletin. 2026.2:51-58. (In Russian) DOI: 10.33266/2782-6430-2026-2-51-58

 

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Conflict of interest. The authors declare no conflict of interest.
Financing. The study had no sponsorship.
Contribution. Article was prepared with equal participation of the authors.
Article received: 12.04.2026. Accepted for publication: 05.05.2026

© 2026 Scientific journal - "Clinical Bulletin of the FMBС im. A.I. Burnasyan"
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