Muitas formas de Strain: Da beleza fisiopatológica a presteza diagnóstica

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http://content.onlinejacc.org/article.aspx?articleid=1146813

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O Strain na ecocardiografia faz um papel parecido com o feito pelo US intracoronário na coronariopatia:

– Revoluciona a interpretação da patologia e sua dinâmica mas não interfere significativamente no tratamento, em termos gerais.

Como a fisiopatologia sempre vence, será apenas uma questão de tempo?

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Finalmente a medida de volume automático chega ao ecocardiografista

Echocardiographic image tracker with a speckle adaptive noise reduction filter for the automatic measurement of the left atrial volume curve

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The mean time required for the LAVT analysis was 1.8 min, for the MDCT analysis was 35.8 min, and for the manual echocardiographic analysis was 14.0 min.

Conclusion This LAVT method is fast, valid, accurate, and reproducible for determining LAV in both simulated images and the clinical setting.

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Medida automática do volume atrial em menos de 2 minutos! 

Agora sim.

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O que os autores acham da nova diretriz americana de válvulas.

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AQUI

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In summary, the 2014 ACC/AHA recommendations for management of AS provide a new framework for thinking about disease severity and seek to align definitions of severity with recommendations for intervention.

The importance of integration of clinical, anatomic, valvular and ventricular measures in defining disease severity is emphasised and the need for healthcare provider teams with expertise in all aspects of patient management is outlined.

With continued improvements in both the TAVR procedure and in the valves themselves, we will continue to see a gradual shift from surgical to transcatheter valve implantation. However, until further data on valve durability are available, surgical AVR will remain the standard for treatment of severe symptomatic AS in patients with a low surgical risk.

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Desde os anos 90 que eu não via diretrizes tão rebuscadas. Lembram a tabela de classificação de Angina do Braunwald , que foi abandonada.

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