PROTOCOLO ECOSTRESS/ VIABILIDAD
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Presentacion realizada por la DSra Violeta Illatopa el dia 14/02/2011 8am , con el objeto de evaaluar la importancia del Ecostress en la busqueda de Viabilidad Miocardica en pacientes con ICC
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PROTOCOLO ECOSTRESS/ VIABILIDAD
- 1. Dra Violeta Illatopa Cerna INCOR Imagenes cardiacas CONSESANDO
- 13. Yao J Am Coll Cardiol 2003;42:1084 –90
- 15. FE 55% IMP 1.706 3.1 Bangalore J Am Soc Echocardiogr 2005;18:1335-1342
- 16. Bangalore J Am Soc Echocardiogr 2005;18:1335-1342
- 17. Yao J Am Soc Echocardiogr 2010;23:832-9.
- 18. Yao J Am Coll Cardiol 2003;42:1084 –90
- 20. Sicari J Am Coll Cardiol 2003;41:589 –95
- 24. Sicari J Am Coll Cardiol 2003;41:589 –95 >= 2 SEGMENTOS
Notas del editor
- Abnormalities in regional function with stress can occur in the absence of epicardial coronary artery obstruction if myocardial perfusion reserv is inadequate to meet myocardial oxygen demand. Assessment of wall thickening and the recognition that ischemia-induced wall-motion abnormalities should follow a typical coronary distribution pattern may help to distinguish septal dyssynchrony from ischemia.100-102 In addition, septal dyssynchrony may result in worsening of septal perfusion and wall thickening at high heart rates in the absence of coronary obstruction.
- Yusuf et al1 and Pitt et al3 showed that patients at high risk for ischemic events but low risk for cardiac death benefit more from medical therapy A normal exercise echocardiogram result is associated with an annual event rate of cardiac death and nonfatal myocardial infarction of less than 1%, equivalent to that of an age- and sex-matched population. These patients do not require further diagnostic evaluation unless there is a change in clinical status.155,156 Patients with a normal pharmacologic stress echocardiogram result have a slightly higher event rate.22 This may be explained by the higher risk status of patients who are unable to perform exercise stress test, as this group tends to be older with more comorbidities.
- 3000 px : EQUIVALE A MSA DE 5 SEGMENTOS QUE PASEN A HIPOCINESIA SEVERA O QUE MAS DE 3 SEGMENTOS PASEN A ACINESIA
- 1000 px IMP1.7: EQUIVALE A MSA DE 5 SEGMENTOS QUE PASEN A HIPOCINESIA SEVERA O QUE MAS DE 3 SEGMENTOS PASEN A ACINESIA
- Yusuf et al1 and Pitt et al3 showed that patients at high risk for ischemic events but low risk for cardiac death benefit more from medical therapy, but patients at intermediate to high risk for cardiac death benefit more from early revascularization. According to this curve estimate, the cardiac death rate exceeded 1% per year for ejection fraction < 50% and 4% per year for ejection fraction < 30%
- diagnostic OR (DOR) Since sensitivity and specificity are only partly representative of a test’s discriminatory performance (ignoring threshold differences), DOR is widely utilised as a single indicator of test performance and is independent of the prevalence of disease.24 It was computed for the included studies as follows: DOR = TP*TN/FP*FN The value of a DOR can range from 0 toinfinity. Higher DOR values are reflective of better discriminatory performance of a diagnostic test
- El usar altas dosis aumenta la sensibilidad y el la rpta bifasica la especificidad Dobutamine stress testing is a useful diagnostic tool for identifying reduced adrenergic myocardial contractile reserve related to altered myocardial expression of beta1-adrenergic receptor, sarcoplasmic reticulum Ca2-adenosine triphosphatase, and phospholamban genes even in asymptomatic or mildly symptomatic patients with DCM. (J Am Coll Cardiol Img 2008;1:718–26) c 2008 by the American College of Cardiology
- Wall thickness should be assessed on the resting echocardiographic images. Segments that are thinned (0.5 or 0.6 cm) and bright (likely a result of advanced fibrosis) rarely recov- Patron de llenado restrictivo en pacientes en terapia lena : no recovery