terça-feira, dezembro 11, 2012
Dia a dia da Diástole no pós Infarto
Serial Doppler Echocardiographic Assessment of Diastolic Dysfunction during Acute Myocardial Infarction
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Conclusions: During STEMI, contrary to findings in stable patients, the predominant Doppler manifestation of the severe diastolic dysfunction and elevated LVEDP was an abnormal relaxation mitral inflow pattern accompanied by E/E' ratios of 8–15. Serial Doppler assessment suggests incomplete diastolic recovery following STEMI.
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Despite the presence of severe diastolic dysfunction and elevated LVEDP, the predominant mitral inflow pattern during acute STEMI was an abnormal relaxation pattern (E/A ratio < 1). This is accompanied by only modestly reduced TDI-derived early diastolic velocities (E'), obtained from the mitral annulus, resulting in observed E/E' ratios in the indeterminate range 8–15 in the majority of patients. Furthermore, serial tissue Doppler assessment shows persistence of diastolic dysfunction at 3 days and then at 1 year follow-up despite successful revascularization.
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Na fase aguda do Infarto a perda de área contrátil é compensada parcialmente pelo aumento da frequencia cardíaca. O enchimento ventricular as custas de pressões atriais elevadas vai se instalando gradualmente. O Eco mostra tudo!
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