Arterial Stiffness, Wave Reflections, and the Risk of Coronary Artery Disease
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Circulation.
2004; 109: 184-189
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Conclusions— AIx (augmentation index) and AP (Augmented pressure), noninvasively determined manifestations of arterial stiffening and increased wave reflections, are strong, independent risk markers for premature coronary artery disease.
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The growing prevalence and associated risk of arterial stiffness provide a major thrust to better understand the underlying molecular, cellular, and genetic causes and the resultant physiological impact of this condition. Elucidation of these mechanisms will aid in more specifically targeted therapeutic interventions because currently available antihypertensive medications fall short at increasing the compliance of the central arterial vessels. Reduction of arterial stiffness of these larger vessels will likely have a significant impact on morbidity and mortality of older adults, as well as diabetic subjects and those with chronic renal disease, and will likely improve quality of life in these populations.
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Arteriosclerosis, Thrombosis, and Vascular Biology.
2005; 25: 932-943
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Esaote QAS do MyLab 60.
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Arterial stiffness has been proposed as an indicator of vascular aging. We aimed to examine this concept by analyzing associations of arterial stiffness with age, subjective and objective measures of physical functioning, and self-reported functional limitation. We measured aortic pulse wave velocity by applanation tonometry among 5392 men and women aged 55 to 78 years. Arterial stiffness was strongly associated with age (mean difference [SE] per decade: men, 1.37 m/s [0.06 m/s]; women: 1.39 m/s [0.10 m/s]). This association was robust to individual and combined adjustment for pulse pressure, mean arterial pressure, antihypertensive treatment, and chronic disease. Participants took an 8.00-ft (2.44-m) walking speed test, a spirometry lung function test, and completed health functioning and (instrumental) activities of daily living questionnaires. Associations of stiffness and blood pressure with physical function scores scaled to SD of 10 were compared. One-SD higher stiffness was associated with lower walking speed (coefficient [95% CI]: −0.96 [−1.29 to −0.64] m/s) and physical component summary score (−0.91 [−1.21 to −0.60]) and poorer lung function (−1.23 [−1.53 to −0.92] L) adjusted for age, sex, and ethnic group. Pulse pressure and mean arterial pressure were linked inversely only with lung function. Associations of stiffness with functional limitation were robust to multiple adjustment, including pulse pressure and chronic disease. In conclusion, the concept of vascular aging is reinforced by the observation that arterial stiffness is a robust correlate of physical functioning and functional limitation in early old age. The nature of the link between arterial stiffness and quality of life in older people merits attention.
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Tempo total do exame: 12 minutos!!!!
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As reuniões da cardiologia são gravadas em vídeo para uso didático.
A partir de agora, as reuniões que contiverem assunto de interesse ao público geral de cardiologistas serão apresentadas no site da disciplina e no blog EchoTalk.
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São gravações ao vivo, sem ensaio, e podem apresentar erros não relevantes ao conteúdo global.
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Exame de rotina, paciente de 64 anos, sem queixas.
O que é esse fluxo diastólico na pulmonar?
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In conclusion, echocardiography screening by TTE and TEE should be routinely performed in all patients with S. aureus bacteraemia in view of the high prevalence and mortality of endocarditis, especially in high-risk patients with prosthetic valves or pre-existing valve disease. It is time to get to the heart of this common severe infection.
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Cada vez mais o eco transesofágico recupera espaço na clínica.
As indicações são ampliadas e o exame não perde para ninguém nessa área de diagnóstico.
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Prediction of the annuloplasty ring size in patients undergoing mitral valve repair using real-time three-dimensional transoesophageal echocardiography
Eur J Echocardiogr (2011) 12 (6): 445-453
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Conclusion Superimposition of annuloplasty ring CAD models on the Live 3D zoom loops of the mitral valve using mitral valve assessment is superior to two-dimensional measurements of the intercommissural distance or the height of the anterior mitral leaflet in predicting correct annuloplasty ring size.
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Apesar de testar o 3D de várias marcas no Euro, foi na SOCESP que eu pude observar com calma o funcionamento da máquina holandesa.
Um agradável passeio pelo mundo real, em 3D, com a técnica da empresa.
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Enquanto ela descrevia as características técnicas, eu me perguntava para que serviria.
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O exame de baixa complexidade pode ser feito em 3 minutos, no tempo pele-transdutor. Depois o paciente se levanta e fazemos as análises com calma.
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O exame de alta complexidade demorará mais, mas como vemos no artigo acima, as informações obtidas são a própria anatomia.
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Já está na hora da ecocardiografia mostrar a anatomia em tempo real. Não os cortes complicados que o clínico bóia sem compreender. Nada daqueles pauzinhos se mexendo para simbolizar as cúspides!
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Vamos mostrar a anatomia, em foto e vídeo, nos laudos e congressos.
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O problema é preço? Não, o problema é de escala.
Aposto como devem ter umas 10 fábricas na China capazes de fazer um aparelho 3D por 50 mil dólares se houver demanda de verdade!
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Os hospitais compram tomos e ressonâncias de 2 milhões mas não compram um 3D Eco por 300 mil.
Não compram porque os ecocardiografistas não se esforçam o suficiente!
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O ecocardiografista ficou tímido nos últimos 10 anos, pois já fez o hospital comprar máquinas de 150 mil dólares para a ecocardiografia apenas porque tinha Color…
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Vamos salvar a ecocardiografia de ponta com a anatomia a 30 quadros por segundo.
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