Loperfido F, Lombardo A, De Luca M, Natali R, Manolfi M, Ierardi C
Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Roma, Italy.
Rays. 1999 Jan-Mar;24(1):60-72.
When analyzing left ventricular wall motion and thickening, two-dimensional echocardiography (2DE) represents a useful non-invasive tool for diagnosing and stratifying ischemic heart disease. New important technical advancements, such as harmonic imaging, allow to overcome limitations due to poor echocardiographic image quality in a large proportion of patients. Combination of exercise or pharmacological stress test with on-line echo images monitoring expands 2DE diagnostic and prognostic value in both ischemia or viability assessment. Study of contrast agents distribution is very promising for clarifying the complex interaction between myocardial perfusion and functional correlates, including myocardial stunning, hibernation and no-reflow phenomena. Direct visualization of epicardial coronary arteries and assessment of coronary artery blood flow has recently been demonstrated to be possible by either transthoracic (TTE) or transesophageal echocardiography (TEE). Acoustic quantification (AQ), automatic border detection (ABD), tissue Doppler imaging (TDI), and color kinesis are other technical modalities which may result to be useful for clinical evaluation of patients with either acute or chronic coronary syndromes.
在分析左心室壁运动和增厚情况时，二维超声心动图（2DE）是诊断和对缺血性心脏病进行分层的一种有用的非侵入性工具。新的重要技术进展，如谐波成像，能在很大比例的患者中克服因超声心动图图像质量差而产生的局限性。运动或药物负荷试验与在线超声图像监测相结合，扩大了2DE在缺血或存活评估中的诊断和预后价值。研究造影剂分布对于阐明心肌灌注与功能相关性之间的复杂相互作用非常有前景，这些相关性包括心肌顿抑、心肌冬眠和无复流现象。最近已证明，经胸超声心动图（TTE）或经食管超声心动图（TEE）都可以直接显示心外膜冠状动脉并评估冠状动脉血流。声学定量（AQ）、自动边界检测（ABD）、组织多普勒成像（TDI）和彩色室壁运动分析是其他技术方式，可能对急性或慢性冠状动脉综合征患者的临床评估有用。
