心衰发病机制及治疗.pptVIP

* Figure 1 Schematic diagram showing the effect of atrioventricular delay duration on Doppler echocardiographic recordings of transmitral flow. With an optimal atrioventricular interval, the mitral valve closes at the end of the A wave. If the atrioventricular delay is too long (middle panel), the E and A waves become fused and the diastolic filling is shortened. Late diastolic mitral regurgitation (MR) may then occur. If the atrioventricular delay is too short (bottom panel), the E and A waves become widely separated and the A wave is truncated by early mitral valve (MV) closure prior to completion of left ventricular filling. * * * * 基底段速度跟快，然后是中段，再后是心尖段。因此基底段斜率更高。 * 注意所有3个节段同步运动 * * * * Patient selection for CRT—present and future. Current indications for CRT according to current European Society of Cardiology (ESC)/European Heart Rhythm Association (EHRA) guidelines13 as well as potential future candidates for CRT are shown. See text for details. CHF, congestive heart failure; LVEF, left ventricular ejection fraction; NYHA, New York Heart Association. * Figure 5 Interventricular interval delay using left ventricular outflow tract (LVOT) measurements of blood flow velocities for estimation of stroke volume (SV). Stroke volume is exponentially related to the left ventricular outflow tract diameter and directly to the velocity–time integral (VTI) of the left ventricular outflow tract. Variation of the interventricular interval (VV) interval affects the stroke volume as evidenced by varying volume–time integral measurements that can serve as surrogate markers for resynchronization. The optimal interventricular interval in this example is derived from pacing the right ventricle (RV) 40 ms before the left ventricle (LV). The optimal atrioventricular delay becomes equal to (optimal AS-LVP) minus the 40 ms interventricular interval. LVP, monochamber LV pacing. Reproduced with permission from Gassis S, Leon AR. Cardiac resynchronization therapy: strategies for device