Dia: 26 de agosto de 2013

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AQUI COMPLETO
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Method and results: Follow-up transthoracic echocardiography (TTE) was performed 3 years after initial TTE in 20 ‘healthy’ HTX patients (13.2 years post-transplantation at time of follow-up) with normal ejection fraction and angiographically ruled out allograft vasculopathy. Grey-scale apical views were recorded and stored for automated offline speckle tracking (EchoPAC 7.0, GE) of the 16 segments of the left ventricle. Strain analysis was performed in 320 segments 34.3 ± 3.7 months after initial assessment. Automated tracking of myocardial deformation for determination of longitudinal systolic strain was not possible in 24 (7.5%) segments at baseline and in 32 (10.0%) segments at follow-up (P = ns). The left ventricular ejection fraction (LVEF) was 61.9 ± 8.1% at the initial examination vs. 62.8 ± 5.8% 3 years afterwards (P = ns). Global longitudinal peak systolic strain was -14.0 ± 4.0 vs. -14.4 ± 2.8%, respectively (P = ns)
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Apparently, deformation values remain stable over the years as long as the LVEF is preserved
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Estudo pioneiro no seguimento de transplantados com Strain. Fora os casos de rejeição, a ligação entre o Strain e a fração de ejeção se mantém confiáveis.

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AQUI >>>>>>>>>>>>>Conclusion: The assessment of longitudinal systolic and diastolic LV and RV functions is valuable during a sub-maximal exercise stress echocardiography to confirm the heart dysfunction related to the HFPEF symptoms. It might be used as a diagnostic test for difficult clinical situations.
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Reparem no protocolo simples:
Sub-maximal exercise test

Following clinical examination, arterial blood pressure measurement (Dinamap Procare Auscultatory 100), 12-lead electrocardiogram, and resting transthoracic echocardiography (Vivid 7, General Electric Healthcare, Horten, Norway), the patients underwent a standard supine exercise echocardiography on a tilting table with an electromagnetic cycle ergometer (Ergometrics). Exercise testing was started at an initial workload of 30W, the workload being increased by increments of 20 W every 2min. The pedaling rate was 60 rpm, the electrocardiogram was recorded continuously, and blood pressure was measured every 2min both on exercise and during recovery from exercise. Exercise testing was interrupted promptly in the case of typical chest pain, limiting breathlessness, dizziness, muscular exhaustion, severe hypertension (systolic blood pressure of >=250 mmHg), or significant ventricular arrhythmia. Blood pressure, ECG, and echocardiographic images were acquired at rest and for a heart rate (HR, 100–120/min) and at least five consecutive beats were recorded. The test should have been considered abnormal if the patient presented one or more of the following criteria: angina, evidence of shortness of breath at low workload level (=2 mm ST segment depression in comparison to baseline levels, rise in systolic blood during exercise <20 mmHg, or a fall in blood pressure and complex ventricular arrhythmias. The exercise duration was planned to be (8–10) min for every patient.