Ribeiro Alcides José Araújo, Ribeiro Andréa Campos de Oliveira, Rodrigues Márcia Marisia Maciel, Negreiros Sandra de Barros Cobra, Nogueira Ana Cláudia Cavalcante, Almeida Osório Luís Rangel, Silva José Carlos Quináglia E, de Paula Ana Patrícia
Hospital de Base do Distrito Federal - HBDF, Unidade de Cirurgia Vascular e Angiologia, Brasília, DF, Brasil.
Clínica Villas Boas, Brasília, DF, Brasil.
J Vasc Bras. 2016 Jul-Sep;15(3):205-209. doi: 10.1590/1677-5449.010015.
Heart diseases can cause changes to vascular ultrasonography (VUS) waveforms in peripheral vessels. These changes are typically bilateral and systemic, they have been little studied, and little is known about them.
To assess peripheral VUS waveforms in elderly patients in order to identify changes caused by heart diseases.
During 2014, a total of 183 elderly patients were examined with peripheral VUS and the results were analyzed.
The sample comprised 102 women (55.7%) and 81 men (44.3%) with ages ranging from 60 to 91 years (mean of 70.4±7.2 years). Abnormalities were identified in VUS waveforms in 84 patients (45.9%). A total of 138 abnormalities were identified and classified into eight of the 13 categories described in the literature, as follows: arrhythmia, systolic pulsus bisferiens, low peak systolic velocity, pulsatile flow in femoral veins, bradycardia, tachycardia, pulsus tardus et parvus and pulsus alternans. There was low agreement between presence/absence of VUS abnormalities and cardiological assessments. Analysis of specific abnormalities revealed variable levels of agreement between VUS and cardiological assessments, ranging from good for tachycardia, moderate for arrhythmia, to low for bradycardia. There was no agreement between VUS and cardiological examinations for the remaining categories of abnormalities.
Certain cardiac abnormalities can be identified in elderly patients by analysis of peripheral VUS waveforms. It is important to recognize and report the presence of these abnormalities because there is a possibility that they may serve to signal hitherto unidentified diagnoses in these patients. However, further studies are needed to determine the importance of changes to peripheral Doppler waveforms to recognition of heart diseases.
心脏病可导致外周血管的血管超声(VUS)波形发生变化。这些变化通常是双侧性和全身性的,对其研究较少,人们对它们了解甚少。
评估老年患者的外周VUS波形,以识别由心脏病引起的变化。
2014年期间,共对183例老年患者进行了外周VUS检查,并对结果进行了分析。
样本包括102名女性(55.7%)和81名男性(44.3%),年龄在60至91岁之间(平均70.4±7.2岁)。84例患者(45.9%)的VUS波形出现异常。共识别出138处异常,并将其分为文献中描述的13类中的8类,如下:心律失常、收缩期双峰脉、收缩期峰值流速低、股静脉搏动性血流、心动过缓、心动过速、迟脉和交替脉。VUS异常的存在与否与心脏评估之间的一致性较低。对特定异常的分析显示,VUS与心脏评估之间的一致性水平各不相同,从心动过速的良好一致性到心律失常的中等一致性,再到心动过缓的低一致性。对于其余异常类别,VUS与心脏检查之间没有一致性。
通过分析外周VUS波形可在老年患者中识别某些心脏异常。认识并报告这些异常的存在很重要,因为它们有可能提示这些患者迄今未被识别的诊断。然而,需要进一步研究以确定外周多普勒波形变化对心脏病识别的重要性。