超声心动图在心力衰竭中的作用课件.pptVIP

超声心动图在心力衰竭中的作用Role of echocardiography in heart failure Prevalence of HFWHO statistics 1996 Prevalence Rate (Million) (/100,000 population) West. Europe 5.3 1,400 East. Europe 1.3 1,300 North America 5.2 1,800 Japan 2.4 1,900 China 12.0 1,000 Definition of HF HF is a clinical syndrome resulting from any structural or functional cardiac disorder that impairs ventricular filling or ejection HF diagnosis = symptoms (dyspnea and fatigue) + signs (fluid retention) No single diagnostic test for HF Echo Modalities M-mode echo Two-dimensional echo Doppler echo Transesophageal echo Three-dimensional echo Contrast echo Doppler tissue imaging Strain rate imaging Echo Evaluation in HF LV systolic function LV diastolic function LV dimension, and volume LV mass and geometry Therapeutic effects Long-term prognosis LV Systolic Dysfunction Decreased myocardial shortening Retarded LV ejection Increased LV end-diastolic volume Elevated left atrial pressure Elevated pulmonary artery pressure Echo Systolic Indices LV dP/dt max Short-axis fractional shortening LV stroke volume Cardiac output LV ejection fraction LV regional systolic function dP/dt max Estimation Limitations Presence of mitral regurgiatation Time-consuming measurements Solution: software program Trivial mitral regrugitation Solution: contrast injection SV CO Measurement SV = EDV — ESV SV = AOA × TVI SV = MOA × TVI CO = SV × HR LVEF Measurement Apical two- four-chamber views End-diastolic and end-systolic frames (one frame before mitral valve closure and opening) Endocardial border drawing Tissue harmonic imaging Modified biplane Simpson rule Limitations Load-dependent Solution: end-systolic/volume relation Time-consuming measurements Solution: ABD technique Unclear endocardial border Solution: contrast injection 二维超声心动图技术的限制性   左室标本及动态三维超声 二维和三维超声测量左室 收缩功能的准确性 三种超声技术诊断左室扩大和EF减低的准确率 左室心肌的三维重建 M型、二维和三维超声测量