Rationale echokardiografische Funktionsdiagnostik

Die rationale echokardiografische Funktionsdiagnostik dient zur Analyse der myokardialen Herzfunktion sowie der Klappenfunktionen. Sie ermöglicht i. d. R. anhand reproduzierbarer standardisierter Bild-Dokumentationen richtige, nachvollziehbare Beurteilungen der Physiologie und Pathophysiologie des Herzens. Der Beitrag erklärt und diskutiert methodische Aspekte bei der Bestimmung bzw. Abschätzung wichtiger numerischer echokardiografischer Parameter.

Abstract

Functional diagnostics by rational echocardiography are the base of a verifiable and reliable analysis of ventricular and valvular function. The most important functional parameters in echocardiography are cardiac volumes – especially total and effective left ventricular stroke volume -, global longitudinal strain, effective orifica areas in valvular stenoses and effective regurgitant volumes, regurgitant fraction and regurgitant orifice areas in valvular regurgitations. Standardized documentation and correct measurements are the prerequisites for accurate echocardiographic estimations. In addition, optimization of image quality supports the correctness of measurements to ensure plausibility of hemodynamics in each individual patient. However, measurements of cardiac volumes by planimetry are error-prone. In addition, calculation of the effective orifice areas using the continuity equation needs methodological accuracy and standardization. Finally, assessment of regurgitant volumes, regurgitant fraction, and regurgitant orifice is often inconsistent with stable hemodynamic conditions – especially by functional assessment the 2D-PISA method. Thus, functional diagnostics by echocardiography in valvular heart diseases should focus on a plausible hemodynamic assessment.

Schlüsselwörter

Echokardiografie - Funktionsdiagnostik - Plausibilität

Key words

echocardiography - functional diagnostics - plausibility

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