The noninvasive assessment of left ventricular diastolic function with two-dimensional and Doppler echocardiography

被引:497
作者
Oh, JK
Appleton, CP
Hatle, LK
Nishimura, RA
Seward, JB
Tajik, AJ
机构
[1] MAYO CLIN SCOTTSDALE, DEPT CARDIOVASC DIS, SCOTTSDALE, AZ USA
[2] LINKOPING UNIV, DEPT CLIN PHYSIOL, LINKOPING, SWEDEN
关键词
PULMONARY VENOUS FLOW; CONGESTIVE-HEART-FAILURE; CORONARY-ARTERY DISEASE; LEFT ATRIAL PRESSURE; HYPERTROPHIC CARDIOMYOPATHY; MITRAL REGURGITATION; CARDIAC AMYLOIDOSIS; CONSTRICTIVE PERICARDITIS; FILLING ABNORMALITIES; SYSTOLIC DYSFUNCTION;
D O I
10.1016/S0894-7317(97)70062-2
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Left ventricular diastolic filling can be determined reliably by Doppler-derived mitral and pulmonary venous flow velocities. Diastolic filling abnormalities ore broadly classified at their extremes to impaired relaxation and restrictive physiology with many patterns in between. An impaired relaxation pattern identifies patients with early stages of heart disease, and appropriate therapy may avert progression and functional disability. Pseudonormalization is a transitional phase between abnormal relaxation and restrictive physiology and signifies increased filling pressure and decreased compliance. In this phase, reducing preload, optimizing afterload, and treating the underlying disease are clinically helpful. A restrictive physiology pattern identifies advanced, usually symptomatic disease with a poor prognosis. Therapeutic intervention is directed toward normalizing loading conditions and improving the restrictive filling pattern, although this may not be feasible in certain heart diseases. Finally, many patients have left ventricular filling patterns that appear indeterminate or mixed. In these cases, clinical information, left atrial and left ventricular size, pulmonary venous flow velocity, alteration of preload help assess diastolic function and estimate diastolic filling pressures.
引用
收藏
页码:246 / 270
页数:25
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