segunda-feira, abril 23, 2012
Vórtice a caminho: Vai ficar mais simples.
VFTa was obtained using the formula: 4 × (1 − β)/π × α³ × LVEF, where β is the fraction of total transmitral diastolic stroke volume contributed by atrial contraction (assessed by time velocity integral of the mitral E- and A-waves) and α is the biplane end-diastolic volume (EDV)1/3 divided by mitral annular diameter during early diastole. Results Mean VFTa was 2.67 ± 0.8 in control subjects; reduced in HF, preserved EF HF, 2.21 ± 0.8; HF with reduced EF, 1.25 ± 0.6 (P< 0.001). It was not affected by age, gender, body surface area but was correlated positively with TD early diastolic myocardial velocities (E′, septal, r = 0.46; lateral, r = 0.43), systolic myocardial velocities (S′, septal, r = 0.47; lateral, r = 0.41), and inversely with the Tei index (r = −0.41); all Ps < 0.001. Sixty-two HF patients (49%) met the composite endpoint. VFTa of <1.32 was associated with significantly reduced event-free survival (Kaplan Meier log rank = 16.3, P= 0.0001) and predicted the endpoint with a sensitivity and specificity of 65 and 72%, respectively. Conclusion VFTa, a dimensionless index, incorporating LV geometry, systolic and diastolic parameters, may be useful in the diagnosis and prognosis of HF . . . . resumo e depois leia aqui o editorial. . . . Todo novo parâmetro é complexo ao nascer. E vai sendo simplificado para o uso com o tempo. . . . Quem estuda física e fisiologia, não consegue fazer um índice prático. O Vórtice aguarda um ecocardiografista que entenda de fisiopatologia. .