The diagnostic usefulness of the mitral E/E′ratio(derived from tissue Doppler imaging) as an estimate of left ventricular filling pressures was studied in 28 patients with diastolic heart failure(defined by heart fai...The diagnostic usefulness of the mitral E/E′ratio(derived from tissue Doppler imaging) as an estimate of left ventricular filling pressures was studied in 28 patients with diastolic heart failure(defined by heart failure signs and symptoms but with preserved ejection fraction) and in 46 patients with systolic heart failure(heart failure signs and symptoms and reduced ejection fraction). E/E′was reflective of filling pressures in subjects with diastolic and systolic heart failure and may be of special use in ruling out elevated filling pressures in subjects with suspected diastolic heart failure.展开更多
Slowed heart rate(HR) recovery after exercise is strongly predictive of increased long-term mortality. The factors responsible for impaired HR regulation are not fully understood. We performed echocardiography with ti...Slowed heart rate(HR) recovery after exercise is strongly predictive of increased long-term mortality. The factors responsible for impaired HR regulation are not fully understood. We performed echocardiography with tissue Doppler imaging in 121 patients before maximal exercise testing. HR recovery was measured 1 minute after the end of exercise in the supine position. The best echocardiographic correlate of HR recovery was the ratio of early mitral flow velocity(E) to early diastolic mitral annular velocity(Ea; r=-0.781, p< 0.001). This correlation was not affected by the use of negative chronotropic agents. Patients whose E/Ea was < 10 had a faster 1-minute HR recovery and a greater chronotropic response during exercise than did those whose E/Ea was ≥10. Receiver-operator characteristic analysis showed that an E/Ea ≥10.3 predicted 1-minute HR recovery of ≤18 beats/min, with 83%sensitivity and 100%specificity. Neither left ventricular ejection fraction nor the presence of a “slow relaxation”mitral inflow pattern(E/A <1.0) was predictive of impaired HR recovery. Thus, slowed HR recovery is strongly associated with increased E/Ea, a marker of increased left ventricular filling pressures. E/Ea at rest may become a simple, reliable, and sensitive predictor of increased long-term mortality, even in the absence of overt heart failure.展开更多
中心静脉压（ central venous pressure, CVP）是指血液经过右心房及上下腔静脉时产生的压力[1]。CVP主要用于测定右心室充盈压反映右心室前负荷，它可反映体内血容量、静脉回心血量、右心室充盈压力或右心功能的变化，可作为临床上补...中心静脉压（ central venous pressure, CVP）是指血液经过右心房及上下腔静脉时产生的压力[1]。CVP主要用于测定右心室充盈压反映右心室前负荷，它可反映体内血容量、静脉回心血量、右心室充盈压力或右心功能的变化，可作为临床上补液速度及补液量的参考指标，对防止心脏负荷过度及指导应用利尿药具有重要参考意义。同时中心静脉压对了解血容量，心功能、心包填塞有着重大意义，也可了解原因不明的急性循环衰竭性质判定具有指导意义；了解少尿或无尿的原因是血容量不足还是肾功能衰竭。展开更多
文摘The diagnostic usefulness of the mitral E/E′ratio(derived from tissue Doppler imaging) as an estimate of left ventricular filling pressures was studied in 28 patients with diastolic heart failure(defined by heart failure signs and symptoms but with preserved ejection fraction) and in 46 patients with systolic heart failure(heart failure signs and symptoms and reduced ejection fraction). E/E′was reflective of filling pressures in subjects with diastolic and systolic heart failure and may be of special use in ruling out elevated filling pressures in subjects with suspected diastolic heart failure.
文摘Slowed heart rate(HR) recovery after exercise is strongly predictive of increased long-term mortality. The factors responsible for impaired HR regulation are not fully understood. We performed echocardiography with tissue Doppler imaging in 121 patients before maximal exercise testing. HR recovery was measured 1 minute after the end of exercise in the supine position. The best echocardiographic correlate of HR recovery was the ratio of early mitral flow velocity(E) to early diastolic mitral annular velocity(Ea; r=-0.781, p< 0.001). This correlation was not affected by the use of negative chronotropic agents. Patients whose E/Ea was < 10 had a faster 1-minute HR recovery and a greater chronotropic response during exercise than did those whose E/Ea was ≥10. Receiver-operator characteristic analysis showed that an E/Ea ≥10.3 predicted 1-minute HR recovery of ≤18 beats/min, with 83%sensitivity and 100%specificity. Neither left ventricular ejection fraction nor the presence of a “slow relaxation”mitral inflow pattern(E/A <1.0) was predictive of impaired HR recovery. Thus, slowed HR recovery is strongly associated with increased E/Ea, a marker of increased left ventricular filling pressures. E/Ea at rest may become a simple, reliable, and sensitive predictor of increased long-term mortality, even in the absence of overt heart failure.
文摘中心静脉压（ central venous pressure, CVP）是指血液经过右心房及上下腔静脉时产生的压力[1]。CVP主要用于测定右心室充盈压反映右心室前负荷，它可反映体内血容量、静脉回心血量、右心室充盈压力或右心功能的变化，可作为临床上补液速度及补液量的参考指标，对防止心脏负荷过度及指导应用利尿药具有重要参考意义。同时中心静脉压对了解血容量，心功能、心包填塞有着重大意义，也可了解原因不明的急性循环衰竭性质判定具有指导意义；了解少尿或无尿的原因是血容量不足还是肾功能衰竭。
