Department of Medicine, Division of Cardiology, Showa University Koto Toyosu Hospital, 5-1-38 Toyosu, Koto-ku, Tokyo, 135-8577, Japan.
Department of Cardiovascular Medicine, Juntendo University School of Medicine, Tokyo, Japan.
Curr Cardiol Rep. 2019 May 10;21(6):53. doi: 10.1007/s11886-019-1138-4.
Noninvasive hemodynamic assessments in patients with heart failure (HF) are essential for appropriate diagnosis and establishment of the best treatment strategies. Recently, the impact of pulmonary circulation and right ventricular function on prognosis in HF patients has drawn increasing attention. In this article, we explore the usefulness of cardiac imaging for hemodynamic assessments, mainly focusing on echocardiographic evaluation.
The reliability of Doppler echocardiography as a noninvasive alternative to Swan-Ganz catheterization has been well investigated with higher than 80% accuracy for estimating pulmonary artery pressure. Strain measurement and three-dimensional echocardiography are useful for evaluating right ventricular function together with pulmonary circulation. The accuracy of analyzing left and right ventricular functions by cardiac computed tomography and cardiac magnetic resonate imaging has also been established. These modalities can provide myocardial tissue information and allow calculation of the extracellular volume fraction as well. According to the rapid improvement of technologies, cardiac imaging has become an essential tool for hemodynamic evaluation in HF management.
心力衰竭(HF)患者的非侵入性血流动力学评估对于明确诊断和制定最佳治疗策略至关重要。最近,肺循环和右心室功能对 HF 患者预后的影响引起了越来越多的关注。本文探讨了心脏影像学在血流动力学评估中的作用,主要侧重于超声心动图评估。
多普勒超声心动图作为 Swan-Ganz 导管插入术的替代方法具有较高的可靠性,其对肺动脉压的估计准确率超过 80%。应变测量和三维超声心动图有助于评估肺循环和右心室功能。心脏计算机断层扫描和心脏磁共振成像分析左、右心室功能的准确性也已得到确立。这些方法可以提供心肌组织信息,并可以计算细胞外容积分数。随着技术的快速进步,心脏影像学已成为 HF 管理中血流动力学评估的重要工具。