Assessing left ventricular systolic function in shock: evaluation of echocardiographic parameters in intensive care.
Assessing left ventricular systolic function in shock: evaluation of echocardiographic parameters in intensive care.
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DOI：
10.1186/cc10368
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发表时间：
2011-08-16
期刊：
影响因子：
--
通讯作者：
Chew MS
中科院分区：
文献类型：
--
作者：
Bergenzaun L;Gudmundsson P;Öhlin H;Düring J;Ersson A;Ihrman L;Willenheimer R;Chew MS
在危重患者中，快速可靠地评估左室（LV）收缩功能是具有挑战性的。本研究的目的是通过连续经胸超声心动图（TTE）评估常用左室收缩参数的可行性和可靠性，以及它们之间的相关性。包括50例休克和机械通气患者。每天进行TTE检查，共7天。评估左室收缩功能的方法包括目测、“眼球”射血分数（EBEF）、Simpson单平面法、平均房室平面位移（AVPDm）、室间隔组织速度成像（TDIs）和左室流出道速度时间积分（VTI）。EBEF、AVPDm、TDIs、VTI和Simpson的检出率分别为100%、100%、99%、95%和93%。Simpson与EBEF的相关r值为0.79 ~ 0.95 （P < 0.01）。与其他左室参数的辛普森相关性随时间变化很大，TDIs和AVPDm的结果最差。VTI（观察者间变异系数4.8%，观察者内变异系数3.1%）和AVPDm（分别为5.3%和4.4%）的重复性最好，Simpson法的重复性最差（分别为8.2%和10.6%）。EBEF和AVPDm在评估机械通气、血流动力学不稳定患者的左室收缩功能时提供了最佳的可行性，而Simpson提供了最差的可行性。此外，辛普森的重复性最差。我们建议在评估这类患者的左室射血分数时，EBEF可以代替单平面Simpson。TDIs和AVPDm作为左室纵向功能的标志，与左室射血分数不可互换。
Assessing left ventricular (LV) systolic function in a rapid and reliable way can be challenging in the critically ill patient. The purpose of this study was to evaluate the feasibility and reliability of, as well as the association between, commonly used LV systolic parameters, by using serial transthoracic echocardiography (TTE). Fifty patients with shock and mechanical ventilation were included. TTE examinations were performed daily for a total of 7 days. Methods used to assess LV systolic function were visually estimated, "eyeball" ejection fraction (EBEF), the Simpson single-plane method, mean atrioventricular plane displacement (AVPDm), septal tissue velocity imaging (TDIs), and velocity time integral in the left ventricular outflow tract (VTI). EBEF, AVPDm, TDIs, VTI, and the Simpson were obtained in 100%, 100%, 99%, 95% and 93%, respectively, of all possible examinations. The correlations between the Simpson and EBEF showed r values for all 7 days ranging from 0.79 to 0.95 (P < 0.01). the Simpson correlations with the other LV parameters showed substantial variation over time, with the poorest results seen for TDIs and AVPDm. The repeatability was best for VTI (interobserver coefficient of variation (CV) 4.8%, and intraobserver CV, 3.1%), and AVPDm (5.3% and 4.4%, respectively), and worst for the Simpson method (8.2% and 10.6%, respectively). EBEF and AVPDm provided the best, and Simpson, the worst feasibility when assessing LV systolic function in a population of mechanically ventilated, hemodynamically unstable patients. Additionally, the Simpson showed the poorest repeatability. We suggest that EBEF can be used instead of single-plane Simpson when assessing LV ejection fraction in this category of patients. TDIs and AVPDm, as markers of longitudinal function of the LV, are not interchangeable with LV ejection fraction.
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影响因子：
6
作者：
Fang, ZY;Leano, R;Marwick, TH
通讯作者：
Marwick, TH
DOI：
10.1053/je.1999.v12.a99246
发表时间：
1999-08-01
影响因子：
6.5
作者：
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通讯作者：
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DOI：
10.1067/mje.2000.107253
发表时间：
2000-10-01
影响因子：
6.5
作者：
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通讯作者：
Wandt, B
DOI：
10.1111/j.1540-8175.2008.00694.x
发表时间：
2008-09-01
影响因子：
1.5
作者：
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通讯作者：
Sizer, Murat
影响因子：
9
作者：
KNAUS, WA;DRAPER, EA;ZIMMERMAN, JE
通讯作者：
ZIMMERMAN, JE