Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Curr Cardiol Rep. 2012 Jun;14(3):359-65. doi: 10.1007/s11886-012-0269-7.
Recent studies have highlighted that dyspneic patients comprise a high-risk subgroup of patients referred for cardiac stress testing. Even after adjusting for the presence and degree of coronary artery disease the risk of cardiac and all-cause mortality is at least three- to fivefold higher in dyspneic patients compared to asymptomatic or those with chest pain. Stress echocardiography is uniquely positioned to characterize all potential cardiovascular etiologies of dyspnea from global and regional systolic dysfunction, myocardial ischemia to valvular heart disease, pulmonary hypertension and diastolic dysfunction. Various data point to diastolic dysfunction and associated heart failure as the major potential etiology for dyspnea as well as the likely cause of the heightened mortality risk. Doppler echocardiography at rest and with stress can now characterize the hemodynamics of diastolic dysfunction and close the loop on the comprehensive assessment of the patient who has exertional shortness of breath. This review discusses the role of the Doppler echocardiographic diastolic stress test in the evaluation of patients with cardiac dyspnea.
最近的研究强调，呼吸困难的患者是心脏应激测试转诊患者中的一个高风险亚组。即使调整了冠状动脉疾病的存在和严重程度，与无症状或胸痛患者相比，呼吸困难患者的心脏和全因死亡率风险至少高出三到五倍。应激超声心动图具有独特的优势，可以从整体和局部收缩功能障碍、心肌缺血到瓣膜性心脏病、肺动脉高压和舒张功能障碍等方面来描述呼吸困难的所有潜在心血管病因。各种数据表明，舒张功能障碍和相关心力衰竭是呼吸困难的主要潜在病因，也是导致死亡率升高的可能原因。现在，静息和应激状态下的多普勒超声心动图可以描述舒张功能障碍的血液动力学，并为运动性呼吸急促患者的全面评估画上句号。这篇综述讨论了多普勒超声心动图舒张应激试验在评估心脏性呼吸困难患者中的作用。
