Diastolic Stress Test for the Evaluation of Exertional Dyspnea
Diastolic Stress Test for the Evaluation of Exertional Dyspnea
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DOI：
10.1007/s11886-012-0269-7
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发表时间：
2012-06-01
影响因子：
3.7
通讯作者：
Oh, Jae K.
中科院分区：
文献类型：
--
作者：
Kane, Garvan C.;Oh, Jae K.
最近的研究强调，呼吸困难患者包括一个高危亚组患者转介心脏压力测试。即使在调整了冠状动脉疾病的存在和程度后，呼吸困难患者的心脏和全因死亡风险至少比无症状或胸痛患者高3 - 5倍。应激超声心动图具有独特的定位，可以表征呼吸困难的所有潜在心血管病因，从整体和局部收缩功能障碍、心肌缺血到瓣膜性心脏病、肺动脉高压和舒张功能障碍。各种数据表明，舒张功能障碍和相关的心力衰竭是呼吸困难的主要潜在病因，也是死亡风险增加的可能原因。静止状态和应激状态下的多普勒超声心动图现在可以表征舒张功能障碍的血流动力学特征，并对用力性呼吸短促患者进行全面评估。本文综述了多普勒超声心动图舒张负荷试验在评价心脏呼吸困难患者中的作用。
Recent studies have highlighted that dyspneic patients comprise a high-risk subgroup of patients referred for cardiac stress testing. Even after adjusting for the presence and degree of coronary artery disease the risk of cardiac and all-cause mortality is at least three-to fivefold higher in dyspneic patients compared to asymptomatic or those with chest pain. Stress echocardiography is uniquely positioned to characterize all potential cardiovascular etiologies of dyspnea from global and regional systolic dysfunction, myocardial ischemia to valvular heart disease, pulmonary hypertension and diastolic dysfunction. Various data point to diastolic dysfunction and associated heart failure as the major potential etiology for dyspnea as well as the likely cause of the heightened mortality risk. Doppler echocardiography at rest and with stress can now characterize the hemodynamics of diastolic dysfunction and close the loop on the comprehensive assessment of the patient who has exertional shortness of breath. This review discusses the role of the Doppler echocardiographic diastolic stress test in the evaluation of patients with cardiac dyspnea.