[Is a totally non-invasive assessment of the hemodynamic profile possible in patients with chronic heart failure?].
Relevant hemodynamic information can be obtained by a comprehensive Doppler echocardiographic examination in patients with various cardiac diseases. The assessment of left heart hemodynamics by Doppler echocardiography has been addressed by several investigators. The feasibility and the accuracy of methods for the estimation of left ventricular filling pressure and cardiac output have been validated by comparative right heart catheterization. Studies have shown that Doppler echocardiography can allow the measurement of pulmonary artery pressures from the pressure gradients across the tricuspid and pulmonary valves. The possibility of completely characterizing cardiac hemodynamics noninvasively has recently been documented: in patients with acute myocardial infarction, automated cardiac output measurement along with the assessment of left ventricular filling by Doppler echocardiography may be used for the identification of hemodynamic subsets. Although Doppler echocardiography can provide noninvasive measures of hemodynamic indices, its value has been disputed since the technique is patient-dependent, time-consuming and requires meticulous acquisition and interpretation by skilled operators. The use of contrast agents may improve the accessibility of both right-sided and left-sided Doppler signals, potentially increasing the number of patients to whom the noninvasive hemodynamic assessment could be applied.
Dini
F L
FL
Unità Operativa di Cardiologia, Ospedale Villamarina, Piombino (LI).
Bezante
G P
GP
Faggiano
P
P
Odaglia
F
F
Micheli
G
G
Barsotti
A
A
D002908:Chronic Disease; D003935:Diagnostic Techniques, Cardiovascular; D006333:Heart Failure / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans