Robertson Institute of Biostatistics and Clinical Trials Unit, University of Glasgow, Glasgow, UK.
Cardiovascular Division, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Eur J Heart Fail. 2021 May;23(5):703-712. doi: 10.1002/ejhf.2032. Epub 2020 Nov 23.
Congestion, related to pressure and/or fluid overload, plays a central role in the pathophysiology, presentation and prognosis of heart failure and is an important therapeutic target. While symptoms and physical signs of fluid overload are required to make a clinical diagnosis of heart failure, they lack both sensitivity and specificity, which might lead to diagnostic delay and uncertainty. Over the last decades, new ultrasound methods for the detection of elevated intracardiac pressures and/or fluid overload have been developed that are more sensitive and specific, thereby enabling earlier and more accurate diagnosis and facilitating treatment strategies. Accordingly, we considered that a state-of-the-art review of ultrasound methods for the detection and quantification of congestion was timely, including imaging of the heart, lungs (B-lines), kidneys (intrarenal venous flow), and venous system (inferior vena cava and internal jugular vein diameter).
充血与压力和/或液体超负荷有关，在心力衰竭的病理生理学、表现和预后中起着核心作用，是一个重要的治疗靶点。虽然心力衰竭的临床诊断需要有液体超负荷的症状和体征，但这些症状和体征缺乏敏感性和特异性，可能导致诊断延迟和不确定性。在过去的几十年中，已经开发出了用于检测升高的心内压力和/或液体超负荷的新的超声方法，这些方法更敏感、更特异，从而能够更早、更准确地诊断，并促进治疗策略。因此，我们认为，及时对用于检测和量化充血的超声方法进行最新综述是适时的，包括心脏、肺部（B 线）、肾脏（肾内静脉血流）和静脉系统（下腔静脉和颈内静脉直径）的成像。
