Samuel T Jake, Beaudry Rhys, Sarma Satyam, Zaha Vlad, Haykowsky Mark J, Nelson Michael D
The University of Texas at Arlington, Engineering Research Building 453, 500 UTA Blvd, Arlington, TX, 76019, USA.
The University of Texas Southwestern Medical Center, Dallas, TX, USA.
Curr Heart Fail Rep. 2018 Dec;15(6):332-339. doi: 10.1007/s11897-018-0409-5.
This review summarizes recent developments highlighting the clinical utility of diastolic stress testing along the heart failure continuum.
Invasive hemodynamic assessment of cardiac filling pressures during physiological stress is the gold-standard technique for unmasking diastolic dysfunction. Non-invasive surrogate techniques, such as Doppler ultrasound, have shown excellent agreement with invasive approaches and are now recommended by the American Society of Echocardiography and the European Association of Cardiovascular Imaging. While cycle exercise is often advocated, recent evidence supports the use of isometric handgrip as a viable alternative stressor. Diastolic stress testing is a powerful tool to enhance detection of diastolic dysfunction, is able to differentiate between cardiac and non-cardiac pathology, and should be incorporated into routine clinical assessment.
本综述总结了近期的进展，突出了舒张期应激测试在心力衰竭连续过程中的临床应用价值。
在生理应激期间对心脏充盈压进行有创血流动力学评估是揭示舒张功能障碍的金标准技术。非侵入性替代技术，如多普勒超声，已显示出与有创方法具有高度一致性，目前被美国超声心动图学会和欧洲心血管影像协会推荐使用。虽然通常提倡进行周期性运动，但最近的证据支持使用等长握力作为一种可行的替代应激源。舒张期应激测试是增强舒张功能障碍检测的有力工具，能够区分心脏和非心脏病变，应纳入常规临床评估。
