Murali S
University of Pittsburgh, School of Medicine, Pittsburgh, PA 15261.
Postgrad Med. 1993 Sep 1;94(3):75-80, 83.
Not only are findings from invasive studies in patients with congestive heart failure important for diagnosis, they may also be crucial in deciding on appropriate treatment and predicting prognosis. Hemodynamic evaluation may be useful for tailoring medical therapy, determining the need for mechanical support, predicting survival, deciding when valve surgery is needed, locating intracardiac shunts precisely, assessing the severity of pulmonary hypertension before cardiac transplantation, or diagnosing unexplained dyspnea. Contrast angiography can be used to evaluate systolic function if information from non-invasive studies is inadequate. Coronary arteriography can help determine the severity and extent of coronary artery disease and is needed if revascularization is being contemplated. Endomyocardial biopsy can be used to identify the cause of cardiomyopathy.
充血性心力衰竭患者的侵入性研究结果不仅对诊断很重要，在决定适当的治疗方案和预测预后方面也可能至关重要。血流动力学评估有助于调整药物治疗、确定是否需要机械支持、预测生存率、决定何时需要进行瓣膜手术、精确确定心内分流的位置、评估心脏移植前肺动脉高压的严重程度或诊断不明原因的呼吸困难。如果非侵入性研究的信息不足，可使用造影血管造影来评估收缩功能。冠状动脉造影有助于确定冠状动脉疾病的严重程度和范围，并且在考虑血运重建时是必需的。心内膜心肌活检可用于确定心肌病的病因。
