Fazer estudo de ICFEp sem Ecoestresse diastólico? Sorry Paragon HF.

https://www.onlinejase.com/article/S0894-7317(16)00044-4/fulltext#sec6

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Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging

Indications

Diastolic stress testing is indicated when resting echocardiography does not explain the symptoms of heart failure or dyspnea, especially with exertion. In general, patients with completely normal hearts and diastolic function at rest with preserved e′ velocity (>7 cm/sec for septal e′, >10 cm/sec for lateral e′) need not undergo stress testing as it is highly unlikely that they will develop diastolic dysfunction and elevated filling pressures with exercise. Likewise, patients with abnormal findings at baseline consistent with elevated LV filling pressures should not be referred for stress testing as the cardiac etiology for dyspnea has already been established and their filling pressures will almost certainly increase further with exercise. The most appropriate patient population for diastolic exercise testing is the group of patients with grade 1 diastolic dysfunction, which indicates delayed myocardial relaxation and normal LA mean pressure at rest.

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Diastolic stress testing is best performed with exercise and not using dobutamine as the administration of the drug does not simulate the day-to-day physiologic stress

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O teste de estresse diastólico é melhor realizado com exercícios e não o uso de dobutamina, pois a administração do medicamento não simula o estresse fisiológico do dia-a-dia.

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https://www.escardio.org/Congresses-&-Events/ESC-Congress/Congress-resources/Congress-news/PARAGON-HF-Do-patients-with-HFpEF-benefit-from-sacubitril-valsartan

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