Bach D S
Department of Internal Medicine, University of Michigan, Ann Arbor, USA.
Prog Cardiovasc Dis. 1997 May-Jun;39(6):543-54. doi: 10.1016/s0033-0620(97)80013-8.
A broad variety of diseases can affect dynamic cardiac function and contribute to exertional symptoms. Although hemodynamic data at rest may be sufficient to guide therapy in some patients with cardiovascular disease, medical and surgical decisions may be impacted by the cardiac response to stress and the ability to associate exertional symptoms with cardiac hemodynamic response. Stress echocardiography/ Doppler provides a unique noninvasive means to evaluate cardiovascular function and ehmodynamic responses during increased cardiac work. Specifically, stress echocardiographic/Doppler imaging allows assessment of the response to exercise of left and right ventricular function, transvalvular and prosthetic valve gradients, and right ventricular systolic pressure. It has substantial clinical use in the evaluation of patients with equivocal evidence of mitral stenosis, suspicion of dynamic mitral insufficiency or prosthetic valve dysfunction, aortic stenosis and impaired left ventricular systolic function, diseases associated with pulmonary hypertension or cor pulmonale, and among patients with dyspnea of unknown origin. The dynamic nature of cardiovascular disease and the broad spectrum of diseases that affect cardiac function make exercise echocardiography/Doppler an ideal tool ideal for the noninvasive assessment of patients with symptoms of exertional dyspnea.
多种疾病可影响心脏动态功能并导致劳力性症状。尽管静息血流动力学数据可能足以指导某些心血管疾病患者的治疗，但药物和手术决策可能会受到心脏对应激的反应以及将劳力性症状与心脏血流动力学反应相关联的能力的影响。负荷超声心动图/多普勒检查提供了一种独特的非侵入性方法，用于评估心脏工作增加时的心血管功能和血流动力学反应。具体而言，负荷超声心动图/多普勒成像可评估左、右心室功能对运动的反应、跨瓣膜和人工瓣膜压差以及右心室收缩压。它在评估二尖瓣狭窄证据不明确、怀疑有动态二尖瓣反流或人工瓣膜功能障碍、主动脉瓣狭窄和左心室收缩功能受损、与肺动脉高压或肺心病相关的疾病以及不明原因呼吸困难患者等方面具有重要临床应用价值。心血管疾病的动态性质以及影响心脏功能的多种疾病使得运动超声心动图/多普勒检查成为评估劳力性呼吸困难症状患者的理想非侵入性工具。
