Predictores ecocardiográficos de capacidad de ejercicio en pacientes con insuficiencia cardiaca sistólica. Valor de la insuficiencia mitral
TL;DR: En pacientes con insuficiencia cardiaca en clase II-III y disfuncion sistolica ventricular izquierda, los principales predictores ecocardiograficos de capacidad de ejercicio se relacionan con the presencia of insufICiencia mitral significativa.
Abstract: Resumen Introduccion y objetivos Pacientes con insuficiencia cardiaca y similar disfuncion sistolica del ventriculo izquierdo tienen diferente capacidad de ejercicio. El objetivo de este estudio es detectar predictores ecocardiograficos de capacidad de ejercicio en pacientes con insuficiencia cardiaca y disfuncion sistolica. Metodos Se incluyo a 150 pacientes con insuficiencia cardiaca en clase II (70%) o III (30%) con fraccion de eyeccion ventricular izquierda Resultados Se detecto insuficiencia mitral en 112 pacientes (75%), que fue significativa en 40 (27%). El grupo 1 evidencio mas insuficiencia mitral significativa (el 35 frente al 18%), area auricular izquierda (27 ± 1 frente a 24 ± 1 cm2), amplitud de E mitral (88 ± 5 frente a 72 ± 3 cm/s) y presion sistolica pulmonar (37 ± 1 frente a 32 ± 1 mmHg; todos p Conclusiones En pacientes con insuficiencia cardiaca en clase II-III y disfuncion sistolica ventricular izquierda, los principales predictores ecocardiograficos de capacidad de ejercicio se relacionan con la presencia de insuficiencia mitral significativa.
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TL;DR: The aim of this study was to identify predictors of exercise capacity in a group of patients with HFpEF and right ventricle (RV) dysfunction.
Abstract: Background and Aim: Predictors of exercise capacity in heart failure (HF) with preserved ejection fraction (HFpEF) remain of difficult determination. The aim of this study was to identify predictor ...
14 citations
TL;DR: In heart failure patients, the impaired LA emptying function is the best predictor of poor exercise capacity, highlighting the need for routine LA size and function monitoring for better optimization of medical therapy in HF.
12 citations
TL;DR: Las publicaciones mas importantes del ano destacan el desarrollo progresivo de las tecnicas de deformacion miocardica y the ecocardiografia tridimensional y the incorporacion creciente al trabajo clinico diario de the resonancia magnetica and the tomografía computarizada.
Abstract: La imagen cardiaca es uno de los pilares de la cardiologia actual. La cantidad de situaciones en que las tecnicas de imagen aportan informacion importante en clinica o investigacion es sencillamente interminable, por lo que es imposible recoger en el formato reducido de un articulo todas las novedades importantes sobre imagen cardiaca que han aparecido en la literatura medica en el ano 2012. Resumimos las publicaciones mas importantes del ano, entre las que destacan el desarrollo progresivo de las tecnicas de deformacion miocardica y la ecocardiografia tridimensional y la incorporacion creciente al trabajo clinico diario de la resonancia magnetica y la tomografia computarizada.
8 citations
TL;DR: Una revision de las aportaciones de las tecnicas de imagen mas relevantes a la cardiologia que se han publicado durante this ano is realiza.
Abstract: Resumen En este articulo se realiza una revision de las aportaciones de las tecnicas de imagen mas relevantes a la cardiologia que se han publicado durante este ano. El ecocardiograma sigue siendo la piedra angular en el diagnostico y el seguimiento de las valvulopatias, con un esfuerzo continuo para mejorar su cuantificacion y obtener parametros pronosticos de seguimiento. El estudio de la funcion miocardica regional se afianza en el diagnostico de la disfuncion ventricular subclinica, y el ecocardiograma transesofagico tridimensional se ha convertido en el perfecto aliado del intervencionismo en las cardiopatias estructurales. La cardiorresonancia y la tomografia computarizada cardiaca acaparan la mayoria de las publicaciones en imagen cardiaca relativas a la cardiopatia isquemica, reflejo de unas tecnicas mas que consolidadas en la practica clinica. La medicina nuclear destaca en el estudio de la viabilidad miocardica tras el intervencionismo en el sindrome coronario agudo y refuerza su rendimiento en el diagnostico de la cardiopatia isquemica.
7 citations
TL;DR: This article summarizes the year's most relevant news on cardiac imaging, highlighting the ongoing development of myocardial deformation and 3-dimensional echocardiography techniques and the increasing use of magnetic resonance imaging and computed tomography in daily clinical practice.
Abstract: Cardiac imaging is one of the basic pillars of modern cardiology. The potential list of scenarios where cardiac imaging techniques can provide relevant information is simply endless so it is impossible to include all relevant new features of cardiac imaging published in the literature in 2012 in the limited format of a single article. We summarize the year's most relevant news on cardiac imaging, highlighting the ongoing development of myocardial deformation and 3-dimensional echocardiography techniques and the increasing use of magnetic resonance imaging and computed tomography in daily clinical practice.
4 citations
References
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TL;DR: A report from the American Society of Echocardiography’s Nomenclature and Standards Committee and The Task Force on Valvular Regurgitation developed in conjunction with the American College of Cardiology EchOCardiography Committee.
3,769 citations
TL;DR: A critical review of echocardiographic and Doppler techniques used in the evaluation of valvular regurgitation in the adult patient is offered, and recommendations for the assessment of severity are provided based on the scientific literature and a consensus of a panel of experts.
Abstract: Valvular regurgitation has long been recognized as an important cause of morbidity and mortality. Although the physical examination can alert the clinician to the presence of significant regurgitation, diagnostic methods are often needed to assess the severity of valvular regurgitation and remodeling of the cardiac chambers in response to the volume overload state. Echocardiography with Doppler has recently emerged as the method of choice for the noninvasive detection and evaluation of the severity and etiology of valvular regurgitation. This article offers a critical review of echocardiographic and Doppler techniques used in the evaluation of valvular regurgitation in the adult patient, and provides recommendations for the assessment of severity of valvular regurgitation based on the scientific literature and a consensus of a panel of experts. Issues of medical management and timing of surgical intervention will not be addressed in this article, as these have been recently published[1].
Valvular regurgitation or incompetence results from various etiologies including valvular degeneration, calcification, fibrosis or infection, alteration of the valvular support apparatus or dilatation of the valve annulus. These conditions cause poor apposition of the valvular leaflets or cusps, and may lead to prolapse, flail, restricted leaflet motion or valvular perforation. With the advent of Doppler techniques that are sensitive to detection of regurgitation, trivial and physiologic valvular regurgitation, even in a structurally normal valve, is now well recognized and is noted to occur frequently in right-sided valves. The following sections describe general considerations of the role of echocardiographic and Doppler techniques in the evaluation of regurgitant lesions.
### Role of Two-dimensional echocardiography
Two-dimensional (2D) echocardiography allows an evaluation of the valvular structure as well as the impact of the volume overload on the cardiac chambers. Calcifications, tethering, flail motion or vegetations can be readily assessed, which can give indirect clues as to the severity of regurgitation. While …
666 citations
TL;DR: HFpEF patients have reduced chronotropic, vasodilator, and cardiac output reserve during exercise compared with matched subjects with hypertensive cardiac hypertrophy and may provide novel therapeutic targets for interventions to improve exercise capacity in this disorder.
Abstract: Background— Nearly half of patients with heart failure have a preserved ejection fraction (HFpEF). Symptoms of exercise intolerance and dyspnea are most often attributed to diastolic dysfunction; however, impaired systolic and/or arterial vasodilator reserve under stress could also play an important role. Methods and Results— Patients with HFpEF (n=17) and control subjects without heart failure (n=19) generally matched for age, gender, hypertension, diabetes mellitus, obesity, and the presence of left ventricular hypertrophy underwent maximal-effort upright cycle ergometry with radionuclide ventriculography to determine rest and exercise cardiovascular function. Resting cardiovascular function was similar between the 2 groups. Both had limited exercise capacity, but this was more profoundly reduced in HFpEF patients (exercise duration 180±71 versus 455±184 seconds; peak oxygen consumption 9.0±3.4 versus 14.4±3.4 mL · kg−1 · min−1; both P<0.001). At matched low-level workload, HFpEF subjects displayed ≈40%...
601 citations
TL;DR: Given the improvement in left ventricle structure and function, along with a low mortality rate, physicians should strongly consider offering mitral valve surgery in combination with the CorCap cardiac support device to patients with heart failure who are on an optimal medical regimen.
225 citations
TL;DR: The severity of MR did not provide independent prognostic information in this group recognized to have uniformly high mortality and hemodynamically significant MR is common among patients with advanced CHF.
191 citations