《2009心脏舒张功能超声诊断标准》由会员分享，可在线阅读，更多相关《2009心脏舒张功能超声诊断标准（27页珍藏版）》请在金锄头文库上搜索。
1、GUIDELINES AND STANDARDSRecommendations for the Evaluation of Left Ventricular Diastolic Function by EchocardiographySherif F. Nagueh, MD, Chair,Christopher P. Appleton, MD,Thierry C. Gillebert, MD,* Paolo N. Marino, MD,* Jae K. Oh, MD,Otto A. Smiseth, MD, PhD,* Alan D. Waggoner, MHS,Frank A. Flachs
2、kampf, MD, Co-Chair,* Patricia A. Pellikka, MD,and Arturo Evangelista, MD,* Houston, Texas; Phoenix, Arizona; Ghent, Belgium; Novara, Italy; Rochester, Minnesota; Oslo, Norway; St. Louis, Missouri; Erlangen, Germany; Barcelona, SpainKeywords: Diastole , Echocardiography, Doppler, Heart failureContin
3、uing Medical Education Activity for “Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography” Accreditation Statement: The American Society of Echocardiography is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medi
4、cal education for physicians. The American Society of Echocardiography designates this educational activity for a maximum of 1 AMA PRA Category 1 Credits. Physicians should only claim credit commensurate with the extent of their participation in the activity.ARDMS and CCI recognize ASEs certificates
5、 and have agreed to honor the credit hours toward their registry requirements for sonographers.The American Society of Echocardiography is committed to resolving all conflict ofinterest issues, and its mandate is to retain only those speakers with financial interests that can be reconciled with the
6、goals and educational integrity of the educational program. Disclosure of faculty and commercial support sponsor relationships, if any, have been indicated. Target Audience: This activity is designed for all cardiovascular physicians, cardiac sonographers, cardiovascular anesthesiologists, and cardi
7、ology fellows. Objectives: Upon completing this activity, participants will be able to: 1. Describe the hemody-namic determinants and clinical application of mitral inflow velocities. 2. Recognizethe hemodynamic determinants and clinical application of pulmonary venous flowvelocities. 3. Identify th
8、e clinical application and limitations of early diastolic flow propagation velocity. 4. Assess the hemodynamic determinants and clinical applica- tion of mitral annulus tissue Doppler velocities. 5. Use echocardiographic methods toestimate left ventricular filling pressures in patients with normal a
9、nd depressed EF, and to grade the severity of diastolic dysfunction. Author Disclosures: Thierry C. Gillebert: Research Grant Participant in comprehensive research agree- ment between GE Ultrasound, Horten, Norway and Ghent University; Advisory Board Astra-Zeneca, Merck, Sandoz. The following stated
10、 no disclosures: Sherif F. Nagueh, Frank A. Flachskampf, Arturo Evangelista, Christopher P. Appleton, Thierry C. Gillebert, Paolo N. Marino, Jae K. Oh, Patricia A. Pellikka, Otto A. Smiseth, Alan D. Waggoner.Conflict of interest: The authors have no conflicts of interest to disclose except as noted
11、above. Estimated time to complete this activity: 1 hourTABLE OF CONTENTSPreface108 I. Physiology108 II. Morphologic and Functional Correlates of Diastolic Dysfunc- tion109 A. LV Hypertrophy109 B. LA Volume109 C. LA Function110 D. Pulmonary Artery Systolic and Diastolic Pressures110III. Mitral Inflow
12、111 A. Acquisition and Feasibility111 B. Measurements111 C. Normal Values111D. Inflow Patterns and Hemodynamics111 E. Clinical Application to Patients With Depressed and Nor- mal EFs111 F. Limitations112 IV. Valsalva Maneuver113 A. Performance and Acquisition113 B. Clinical Application113 C. Limitat
13、ions113 V. Pulmonary Venous Flow113 A. Acquisition and Feasibility113 B. Measurements113 C. Hemodynamic Determinants114 D. Normal Values114 E. Clinical Application to Patients With Depressed and Nor- mal EFs114 F. Limitations114 VI. Color M-Mode Flow Propagation Velocity114 A. Acquisition, Feasibili
14、ty, and Measurement114 B. Hemodynamic Determinants114 C. Clinical Application115 D. Limitations115 VII. Tissue Doppler Annular Early and Late Diastolic Veloci- ties115 A. Acquisition and Feasibility115 B. Measurements115 C. Hemodynamic Determinants116 D. Normal Values116 E. Clinical Application116 F
15、. Limitations117 VIII. Deformation Measurements118 IX. Left Ventricular Untwisting118 A. Clinical Application118From the Methodist DeBakey Heart and Vascular Center, Houston, TX (S.F.N.); Mayo Clinic Arizona, Phoenix, AZ (C.P.A.); the University of Ghent, Ghent, Belgium (T.C.G.); Eastern Piedmont Un
16、iversity, Novara, Italy (P.N.M.); Mayo Clinic, Rochester, MN (J.K.O., P.A.P.); the University of Oslo, Oslo, Norway (O.A.S.); Washington University School of Medicine, St Louis, MO (A.D.W.); the University of Erlangen, Erlangen, Germany (F.A.F.); and Hospital Vall dHebron, Barcelona, Spain (A.E.).Reprint requests: American Society of Echocardiography, 2100 Gateway Centre Boulevard, Suite 310, Morrisville, NC 27560 (E-mail: aseasecho.org).*Writing Committee of the European Associatio
