O verdadeiro estudo que orientou a nova diretriz de Diástole Britânica

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In 46 patients, filling pressure was measured during left heart catheterization as LV pre-atrial contraction (pre-A) pressure and in 6 patients where pre-A pressure was not possible to assess, as LV end-diastolic pressure

In 276 (86%) patients, LV filling pressure was measured during right heart catheterization as end-expiratory pulmonary capillary wedge pressure (PCWP)

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https://doi.org/10.1093/ehjci/jeaa415

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Reproducibility of LA reservoir and pump strain

Two observers analysed 25 randomly selected patients in the core lab. The interobserver ICCs for LA reservoir and pump strain was 0.89 and 0.82, respectively. The corresponding intraobserver ICCs were 0.93 and 0.92, respectively.

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Feasibility was apparently slightly better (96%) in the present study, probably reflecting the exclusion of patients with technically inadequate echocardiograms.

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The subgroups with LBBB, non-cardiac pulmonary hypertension, restrictive or hypertrophic cardiomyopathy, and mitral regurgitation were too small to make definite conclusions about the utility of LA strain for the evaluation of LV filling pressure in these disorders

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In the subgroup with atrial fibrillation, which was somewhat larger, the LA reservoir strain values were <20% regardless of LV filling pressure (Supplementary data online, Figure S1). This indicates that LA strain cannot be used to assess LV filling pressure in patients with atrial fibrillation

Ecoestresse físico cuida melhor do mundo

Nos EUA, com base em dados do Conselho Nacional de Proteção contra Radiação e Medições, a exposição anual à radiação médica per capita por ano diminuiu de 3,0 mSv (equivalente a 150 raios-X de tórax) em 2006 para 2,2 mSv (equivalente a 110 raios-X de tórax) em 2016.

Esse declínio foi atribuído, em grande parte, a uma queda nos exames de cardiologia nuclear, incluindo a tomografia por emissão de pósitrons (de 9,1 milhões em 2006 para 6,4 milhões em 2016), em grande parte substituída por SE.

10 Pequeno gasto econômico, não ionizante, danos mínimos à radiação e impacto ambiental modesto por varredura multiplicado por bilhões de exames por ano tornam-se um custo social reduzido, baixos danos à saúde da população e pegada ambiental.