According to the ACC/AHA recommendations, the diagnosis of congestive HF is defined by the association of structural heart disease with symptoms compatible with the diagnosis. In the light of the present review, we can state that tissue Doppler evidence of pulmonary capillary hypertension at rest and unmasked during exercise is likely to become a hallmark for the diagnosis of congestive HF in the setting of preserved LV systolic function, regardless of the clinical presentation.
Sabe a discussão antiga, existe síndrome metabólica ou seria apenas a junção de fatores de riscos?
O insuficiência cardíaca com fração de ejeção preservada anda na mesma direção.
Vale a pena ler o texto acima.
Echocardiography is the ideal technique to evaluate TR. It pro-
vides the following information:
It is similar to MR in that the presence of structural abnormal-
ities of the valve distinguishes between its primary or secondary
forms. In primary TR, the aetiology can usually be identified
from specific abnormalities such as vegetations in endocarditis,10
leaflet thickening and retraction in rheumatic and carcinoid
disease, prolapsing/flail leaflet in myxomatous or post-traumatic
disease, and dysplastic tricuspid valve in congenital diseases such
as Ebstein’s anomaly.11 The degree of dilatation of the annulus
should also be measured.17 Significant tricuspid annular dilata-
tion is defined by a diastolic diameter ≥40 mm or .21 mm/
m2 in the four-chamber transthoracic view.17,178–180 In second-
ary TR, a coaptation distance .8 mm characterizes patients
with significant tethering (distance between the tricuspid
annular plane and the point of coaptation in mid-systole from
the apical four-chamber view).181
Evaluation of TR severity and pulmonary systolic pressure
should be carried out as currently recommended (Table 5).17
Evaluations of the RV dimensions and function should be con-
ducted, despite existing limitations of current indices of RV func-
tion. Tricuspid annular plane systolic excursion (TAPSE) (,15 mm),
tricuspid annulus systolic velocity (,11 cm/s), and RV end-systolic area (.20 cm2)
could be used to identify patients with RV dysfunction