quarta-feira, setembro 09, 2009

A avaliação diastólica não ajuda o paciente?


Doppler Echocardiography Yields Dubious Estimates of Left Ventricular Diastolic Pressures
.Circulation. 2009;120:810-820
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Doppler echocardiography provided major insights into the pathophysiology of diastolic LV dysfunction. So far, however, no single Doppler echocardiographic index of diastolic LV dysfunction has yielded a robust criterion for elevated LV filling pressures. Furthermore, a stepwise strategy with sequential use of multiple Doppler echocardiographic indexes reduces diagnostic sensitivity because it frequently leads to an indeterminate outcome with a positive score on 1 test and a negative on another
Because of these persistent shortcomings, clinicians should continue to make critical use of current Doppler echocardiographic estimates of LV filling pressures and should not hesitate to implement invasive investigations to confirm their clinical suspicions.

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