[Assessment of coronary heart diseases by echocardiography].
Echocardiography plays an important role in deciding the operative indication in patients with coronary artery diseases. On deciding the indication of coronary artery bypass graft, dobutamine stress echocardiography provides accurate information on presence or absence of myocardial ischemia and of myocardial viability in each coronary artery territory. Assessment of the coronary blood flow velocity using high-frequency Doppler enables us to examine the presence of coronary stenosis and the patency of bypass graft. Left ventricular remodeling is a cause of progressive heart failure after myocardial infarction, and echocardiography allows us to measure the left ventricular volume and ejection fraction. Real-time 3-dimensional echocardiography has made this measurement process accurate and easy. Dyssynchrony is another mechanism that worsens ventricular contractile performance, and several echocardiographic indexes were proposed to diagnose it. Cardiac resynchronization therapy, if it is performed with cardiac surgery, can correct the dyssynchrony and enhance the functional improvement. Severity of diastolic dysfunction can predict the prognosis of patients with coronary artery diseases, and we can assess it from the mitral flow velocity pattern; normal, abnormal, pseudonormal and restrictive. Thus, echocariography provides a potential method to evaluate myocardial viability, myocardial ischemia, and pathophysiology of heart failure.
Ito
Hiroshi
H
Division of Cardiology, Sakurabashi Watanabe Hospital, Osaka, Japan.
D001783:Blood Flow Velocity; D001026:Coronary Artery Bypass; D003326:Coronary Circulation; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D025401:Echocardiography, Stress; D019560:Echocardiography, Three-Dimensional; D006801:Humans; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000503:physiopathology; D020257:Ventricular Remodeling