[The role of Doppler echography in the evaluation of systolic and/or diastolic dysfunction of the left ventricle].
The doppler-echocardiographic assessment of left ventricular systolic and diastolic dysfunction involves numerous indices. Preload is evaluated by measurement of the end-diastolic left ventricular diameter and sometimes by the rapid filling E wave on doppler recordings. The best index of of afterload is the end-systolic stress. Most indices of contractility are load-dependent, including percentage of fibre shortening, FCV, FCVc, EF. This leads to the construction of end-systolic regression slopes by varying the load to determine the myocardial contractile value. In the future, automated analysis of doppler curves will be used to determine the aortic flow maximal acceleration. The diastolic function is easily evaluated through the transmitral flow, but its interpretation must take into account the patient's age, heart rate and filling state. Two aspects are regarded as pathological: the filling disorder aspect with E/A under 1, and the hypernormal assay described by Appleton. In doppler-echocardiographic studies as well as in haemodynamic studies all these indices are interrelated, which shows the complexity of cardiac physiology and the interdependence of its factors.
Duval-Moulin
A M
AM
Service de cardiologie, hôpital Henri-Mondor, Créteil.
D003971:Diastole / Q000502:physiology; D015150:Echocardiography, Doppler / Q000379:methods*; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D009200:Myocardial Contraction / Q000502:physiology; D013599:Systole / Q000502:physiology; D016277:Ventricular Function, Left
Rôle de l'écho-doppler dans l'évaluation des dysfonctions systoliques et/ou diastoliques du ventricule gauche.