Noninvasive Evaluation of Right Atrial Pressure
Noninvasive Evaluation of Right Atrial Pressure
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DOI：
10.1016/j.echo.2013.06.004
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发表时间：
2013-09-01
影响因子：
6.5
通讯作者：
Siegel, Robert J.
中科院分区：
文献类型：
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作者：
Beigel, Roy;Cercek, Bojan;Siegel, Robert J.
在目前的实践中，右房压力(RAP)是患者血流动力学评估的重要组成部分，也是无创性估测肺动脉压的必要条件。RAP提供对血管内容量的估计，这是优化患者护理和管理的关键组成部分。RAP增加与不良结局相关，并且与心血管疾病患者的全因死亡率独立相关。虽然评估RAP的金标准是有创监测，但有多种技术可用于无创评估RAP。已有多种超声心动图方法用于评价RAP，包括从下腔静脉、体静脉和肝静脉获得的指数、组织多普勒参数和右心房内径。由于RAP的非侵入性评估涉及间接测量，因此必须考虑多种因素才能提供最准确的RAP评估。作者回顾了支持当前指南的数据，确定了一致、冲突、限制和不确定性的领域。
In current practice, right atrial pressure (RAP) is an essential component in the hemodynamic assessment of patients and a requisite for the noninvasive estimation of the pulmonary artery pressures. RAP provides an estimation of intravascular volume, which is a critical component for optimal patient care and management. Increased RAP is associated with adverse outcomes and is independently related to all-cause mortality in patients with cardiovascular disease. Although the gold standard for RAP evaluation is invasive monitoring, various techniques are available for the noninvasive evaluation of RAP. Various echocardiographic methods have been suggested for the evaluation of RAP, consisting of indices obtained from the inferior vena cava, systemic and hepatic veins, tissue Doppler parameters, and right atrial dimensions. Because the noninvasive evaluation of RAP involves indirect measurements, multiple factors must be taken into account to provide the most accurate estimate of RAP. The authors review the data supporting current guidelines, identifying areas of agreement, conflict, limitation, and uncertainty.