Yancy Clyde, Abraham William T
Department of Internal Medicine, Cardiology Division, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA.
Congest Heart Fail. 2003 Sep-Oct;9(5):241-50. doi: 10.1111/j.1751-7133.2003.tb00021.x.
The annual health care cost incurred by heart failure patients is about $56 billion, two thirds of which is spent on management of acutely decompensated patients. Hemodynamic evaluation is helpful for optimization of treatment, monitoring clinical outcomes, and overall prognostication of heart failure patients, but historically could only be obtained via costly invasive procedures that carry substantial risks. Impedance cardiography (ICG) is a noninvasive and economical outpatient procedure that has been shown to provide reliable hemodynamic values comparable to those obtained from pulmonary artery catheterization. Recent clinical studies involving hundreds of patients have validated the accuracy and reproducibility of ICG compared with invasive techniques. The direct and derived measurements and the clinical applications of ICG in the diagnosis and treatment of heart failure are presented, as are three clinical case studies demonstrating the utility of ICG in the hemodynamic-guided management of heart failure. ICG is a viable, noninvasive technique in early- and late-stage heart failure that provides assistance in diagnostic evaluation, longitudinal prognostication, and therapeutic decisions.
心力衰竭患者每年产生的医疗费用约为560亿美元，其中三分之二用于急性失代偿患者的管理。血流动力学评估有助于优化治疗、监测临床结果以及对心力衰竭患者进行整体预后评估，但从历史上看，只能通过成本高昂且风险巨大的侵入性手术来获取相关信息。阻抗心动图（ICG）是一种非侵入性且经济的门诊检查方法，已被证明能够提供与通过肺动脉导管插入术获得的血流动力学值相当的可靠结果。最近涉及数百名患者的临床研究证实了ICG与侵入性技术相比的准确性和可重复性。本文介绍了ICG在心力衰竭诊断和治疗中的直接测量值、衍生测量值及其临床应用，还展示了三个临床案例研究，以证明ICG在心力衰竭血流动力学指导管理中的作用。ICG是一种可行的非侵入性技术，可用于早期和晚期心力衰竭，有助于诊断评估、长期预后判断以及治疗决策。
