of diastolic function harvard university左室舒张功能的评价哈佛大学课件

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1、EchocardiographicEvaluationofLVDiastolicFunctionNatalieBello,M.D.October14,2009ObjectivesDefiningDiastoleDiastolicFunctionMeasurementsDiastolicFunctionGradesDiastology:Thescienceandartofcharacterizingleftventricularrelaxation,fillingdynamics,andtheirintegrationintoclinicalpractice.WhatisDiast

2、ole?InsertOttoFigure7-1+/-7-2ObjectivesDefiningDiastoleDiastolicFunctionMeasurementsDiastolicFunctionGradesTransmitralDopplerInflowhttp://www.echobasics.de/diastole-en.htmlIVRThttp://www.echobasics.de/diastole-en.htmlTissueDopplerImaging(e’)TissueDopplerImaging(e’)E/e’ratio(combooftransmitral

3、flowvelocityandannularvelocity)isbestparameterforpredictingmeanLVEDP(<8nl,>15abnl);butcannotbeusedinisolation!http://www.echobasics.de/diastole-en.htmlPulmonaryVenousDopplerFlowMitralInflowPropagationVelocity(Vp)http://www.echobasics.de/diastole-en.htmlGlobalStrainRate(SRivr)WangetalGlobalDia

4、stolicSRforLVRelaxationCirc.2007;115:1376-1383.LAVolumeBarometerofthechronicityofdiastolicdysfunction.LAvolumecorrelateswithriskofcardiovasculareventsincludingMI,CVA,AfibandCHF.MorestablethanLVfillingpressures.DouglasPS.Theleftatrium:abiomarkerofchronicdiastolicdysfunctionandcardiovasculardis

5、easerisk.JACC2002;42:1206-7.ObjectivesDefiningDiastoleDiastolicFunctionMeasurementsDiastolicFunctionGradesBIDMCEchoLabDecelTime140-250msE/e’:<8normalE/e’>15(LVEDP>18mmHg)ApproachtothePatientSummaryDiastoleisacomplex,energydependentprocess.Echoindicesofdiastolicfninclude:TransmitralDopplerinfl

6、owTissueDopplervelocitiesPulmonaryvenousDopplerflowColorM-modepropagationvelocityDiastolicdysfunctionisameasurable,step-wiseprogressionfromnormaltoirreversible.ReferencesOttoCM.Textbookofclinicalechocardiography,4thEdition.DouglasPS.Theleftatrium:abiomarkerofchronicdiastolicdysfunctionandrela

7、tiontocardiovascularriskburden.JACC2002;40:1206-7.http://www.echobasics.de/diastole-en.htmlLesterSJ,TajikAJ,NishimuraRA,etal.Unlockingthemysteriesofdiastolicfunction.JACC2008;51:679-89.NaguehSF,etal.Recommendationsfortheevaluationofleftventri