Nishimura R A, Tajik A J
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
J Am Coll Cardiol. 1997 Jul;30(1):8-18. doi: 10.1016/s0735-1097(97)00144-7.
Abnormalities of diastolic function have a major role in producing the signs and symptoms of heart failure. However, diastolic function of the heart is a complex sequence of multiple interrelated events, and it has been difficult to understand, diagnose and treat the various abnormalities of diastolic filling that occur in patients with heart disease. Recently, Doppler echocardiography has been used to examine the different diastolic filling patterns of the left ventricle in health and disease, but confusion about diagnosis and treatment options has arisen because of the misinterpretation of these flow velocity curves. This review presents a simplified approach to understanding the process of diastolic filling of the left ventricle and interpreting the Doppler flow velocity curves as they relate to this process. It has been hypothesized that transmitral flow velocity curves show a progression over time with diseases involving the myocardium. This concept can be applied clinically to estimate left ventricular filling pressures and to predict prognosis in selected groups of patients. Specific therapy for diastolic dysfunction based on Doppler flow velocity curves is discussed.
舒张功能异常在心力衰竭症状和体征的产生中起主要作用。然而，心脏舒张功能是一系列复杂的、多个相互关联的事件，理解、诊断和治疗心脏病患者出现的各种舒张期充盈异常一直很困难。最近，多普勒超声心动图已被用于检查健康和疾病状态下左心室不同的舒张期充盈模式，但由于对这些流速曲线的错误解读，在诊断和治疗选择方面出现了混淆。本综述提出了一种简化的方法，用于理解左心室舒张期充盈过程，并解读与该过程相关的多普勒流速曲线。据推测，随着涉及心肌的疾病发展，经二尖瓣流速曲线会随时间发生变化。这一概念可在临床上用于估计左心室充盈压，并预测特定患者群体的预后。本文还讨论了基于多普勒流速曲线的舒张功能障碍的具体治疗方法。
