Ebook A practical approach to clinical echocardiography: Part 2
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Ebook A practical approach to clinical echocardiography: Part 2
CHAPTER12Diastolic Functionn INTRODUCTION________________________________Roth ventricles ofthc heart arc bidirectional hemodynamic pumps and engage in Ebook A practical approach to clinical echocardiography: Part 2n functions of suction (relaxation) and ejection (contraction). Relaxation aids io filing during diastole, and therefore, filing parameters denote diastolic function. T c phenomena of relaxation and contraction are interlinked and energy-dependent. Diastole precedes systole, because no ejection is p Ebook A practical approach to clinical echocardiography: Part 2ossible unless there is filing frst. T c processes of relaxation and filing constitute diastolic function. Increased resistance to filing is the simplEbook A practical approach to clinical echocardiography: Part 2
est way of defning diastolic dysfunction. Diastolic dysfunction is the frst manifestation of a disease process and explains the symptoms better. AbnorCHAPTER12Diastolic Functionn INTRODUCTION________________________________Roth ventricles ofthc heart arc bidirectional hemodynamic pumps and engage in Ebook A practical approach to clinical echocardiography: Part 2 on Doppler echocardiographic visualization of infow and/or ventricular tissue re-extension, although many more parameters are described.T e study of pressure volume loop during diastole is the ideal way to understand and assess diastolic function. However, there are several surrogate methods and pa Ebook A practical approach to clinical echocardiography: Part 2rameters in echo-Doppler techniques, which provide reasonable, reliable and actionable information about diastolic function. In general, diastolic dysEbook A practical approach to clinical echocardiography: Part 2
function maybe characterized by enlargement of upstream chamber (atrium), alteration in various phases of diastole and raised filing pressures. HoweveCHAPTER12Diastolic Functionn INTRODUCTION________________________________Roth ventricles ofthc heart arc bidirectional hemodynamic pumps and engage in Ebook A practical approach to clinical echocardiography: Part 2l situation, like exercise, may provide enhanced information. Diastolic compensatory mechanisms that maintain filing volume are the earliest evidence of dysfunction. 1 ere is also evidence of regional diastolic wall motion nonuniformity. Noninvasivc surrogates often reported in clinical studies refe Ebook A practical approach to clinical echocardiography: Part 2ct integrative properties that lack specifcily.□ PHYSIOLOGY OF DIASTOLEDiastolic dysfunction is rhe physiological expression of morphological cardiovaEbook A practical approach to clinical echocardiography: Part 2
scular disease. T c healthy myocardium is an active, nonlinear, nonhomogeneous and anisotropic viscoelastic material. During diastolic lengthening, noCHAPTER12Diastolic Functionn INTRODUCTION________________________________Roth ventricles ofthc heart arc bidirectional hemodynamic pumps and engage in Ebook A practical approach to clinical echocardiography: Part 2a (Fig. 12.11.T ere IS a certain degree of systolic elastance and also a def nite degree of diastolic elastance.1 Tn several disease states like hypertension, diabetes and left ventricular hypertrophy as also with aging, systolic elastance remains unaffected or may actually increase, and diastolic e Ebook A practical approach to clinical echocardiography: Part 2lastance decreases, which can be studied and assessed by echo-Doppler parameters of diastolic function (Fig. 12.2).On the other hand, when systolic elEbook A practical approach to clinical echocardiography: Part 2
astance is reduced, diastolic elastance initially increases due to remodeling and diastolic dysfunction denoted by filing pressures, therein, is a manCHAPTER12Diastolic Functionn INTRODUCTION________________________________Roth ventricles ofthc heart arc bidirectional hemodynamic pumps and engage in Ebook A practical approach to clinical echocardiography: Part 2iasluk* ts 0 nvrror tm&se or systole.(ÍVR Isovoluiriic letaxalicin, IVC IsuwAinlic onriltaclxiti RF R-ipiil filling AS Atrial systole)Fig. 12.2: PksziuiO velum!.- l:x:p uf ;i riuniMl subject (green ciAx) »nd that or a suttee: with diastolic dysfunction (red color). Note the same end systolic efaslar Ebook A practical approach to clinical echocardiography: Part 2itX! tail with reduced end diaslolii: etastariiZ!Fig. 12.3: Diastole dystuncoon in clinical sense IS raised diastole [xcssixr.s, which means trxiuendEbook A practical approach to clinical echocardiography: Part 2
cxxiipliatxxỉ nt inrrnasixl liixslofc: stirtness.diseases affect the left ventricle (LV) primarily, and therefore. Il IS pertinent to discuss largely CHAPTER12Diastolic Functionn INTRODUCTION________________________________Roth ventricles ofthc heart arc bidirectional hemodynamic pumps and engage in Ebook A practical approach to clinical echocardiography: Part 2•Passive effects of connective tissue•Rapid changes in atrial and ventricular pressures•Transmural fow•Interactions with the right ventricle and pericardium•Atrial systole□ SIGNIFICANCE OF DIASTOLIC FUNCTION•Tdcntifcation of prcclinical diseases in probands•Diagnosis of clinical syndrome of heart fa Ebook A practical approach to clinical echocardiography: Part 2ilure•Marker of incremental prognosis in diverse cardiacdisorders•Monitoring therapy and follow-up•Understanding exercise physiology•Cardiac versus noEbook A practical approach to clinical echocardiography: Part 2
n cardiac dyspnea•Physiological versus pathological remodeling•Optimizing devices and drugs response•Evaluation of in Ira ventricular dyssynchrony•StuCHAPTER12Diastolic Functionn INTRODUCTION________________________________Roth ventricles ofthc heart arc bidirectional hemodynamic pumps and engage inCHAPTER12Diastolic Functionn INTRODUCTION________________________________Roth ventricles ofthc heart arc bidirectional hemodynamic pumps and engage inGọi ngay
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