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Revista Uruguaya de Cardiología
versión On-line ISSN 1688-0420
Resumen
FLORIO, LUCíA et al. Factibilidad de la valoración hemodinámica ecocardiográfica no invasiva en la insuficiencia cardíaca crónica. Rev.Urug.Cardiol. [online]. 2006, vol.21, n.2, pp.117-123. ISSN 1688-0420.
SUMMARY The aim of this trial is to define the feasibility of cardiac echo Doppler to estimate hemodinamic pattern and establish its characteristics in a group of out- hospital patients with chronic heart failure, assisted in Hospital de Clínicas (HC), Montevideo Uruguay. Material and method: thirty consecutive patients sent to be evaluated in the heart failure policlinic of HC were included between October 2003 and July 2004. Positive Boston criterions for the diagnosis of heart failure and/or ejection fraction of left ventricle (EFLV) less or equal to 40% and sinus rhythm were required. Medium age: 61[46-90] years, 23 men(77%), functional class (FC): FC I: 17 (57%), FC II: 8 (27%), FC III: 5 (16%); treated according Task Force of Heart Failure AHA/ACC: angiotensine enzime converter inhibitor in 26 patients (87%), beta blockers 18 (60%), diuretics 22 (73%). Cardiac echo Doppler was performed with ATL CX 2000 equipment, EFLV, left ventricule input pattern (LVIP) [(normal (N), abnormal relaxation (AR), pseudonormal (P) o restrictive (R)], cardiac index (CI, l/min/m2), systemic vascular ressistance (SVR, d.s.cm-5) and pulmonar vascular ressistance (PVR), d.s.cm-5) were determined. LVEF medium 31% [16-65]), LVIP distribution: AR: 19 (64%), P: 7 (23%), R: 3 (10%). All patients FC III had R or P LVIP. Results: SVR was possible to estimate in 97% of cases (29/30), PVR in 27% (8/30), CI in 100% (30/30). Medium CI: 2,01 l/min/m2 [0,78-2,92], medium SVR 1.844 d.s.cm-5 [1.013-5.706], medium PVR 178 d.s.cm-5 [90-298]. In 83% of patients (25/30), SVR was greater than1.200 d.seg.cm-5 and in 66% (20/30), CI was lower than 2,2 l/min/m2. Conclutions: Estimation of hemodinamic pattern of chronic heart failure patients by cardiac echo Doppler is feasible with exception of PVR. It is characterized by low cardiac index and high systemic vascular ressistance.
Palabras clave : ECOCARDIOGRAPHY, DOPPLER; HEART FAILURE; CONGESTIVE; FEASIBILITY STUDIES.