Echokardiografische Parameter bei der diastolischen Herzinsuffizienz

Abstract

Diastolic heart failure or heart failure with normal or preserved ejection fraction (HFnEF, HFpEF) is defined by symptoms and clinical signs as well as normal dimension of the left ventricle and a left ventricular ejection fraction > 50 % combined with structural changes like left ventricular hypertrophy, left atrial dilatation and diastolic dysfunction. Despite this definition the cohort of so-called HFnEF/HFpEF patients is heterogeneous and has to be characterised more precisely. Conventional transthoracic echocardiography enables a subtle analysis of diastolic function, but standardisation of views and accurate acquisition of Doppler spectra is the prerequisite for the graduation of diastolic dysfunction and the detection of increased left ventricular enddiastolic pressure. Modern features of echocardiography like speckle tracking and 3D-echocardiography as well as cardiac MRI will help to enable a better characterisation of patients with HFnEF/HFpEF.

• Literatur

• 1 Paulus WJ, Tschöpe C, Sanderson JE et al. How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology. Eur Heart J 2007; 28: 2539-2550
• 2 Udelson JE. Heart failure with preserved ejection fraction. Circulation 2011; 124: e540-e543
• 3 Paulus WJ, Tschöpe C. A novel paradigm for heart failure with preserved ejection fraction. J Am Coll Cardiol 2013; 62: 263-271
• 4 Desai AS. Heart failure with preserved ejection fraction. J Am Coll Cardiol 2013; 62: 272-273
• 5 Asrar ul Haq M, Mutha V, Hare DL et al. Heart failure with preserved ejection fraction – unwinding the diagnosis mystique. Am J Cardiovasc Dis 2014; 4: 110-113
• 6 McMurray JJV, Adamopoulos S, Anker SD et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012. Eur Heart J 2012; 33: 1787-1847
• 7 Nagueh SF, Appleton CP, Gillebert TV et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. Eur J Echocardiography 2009; 10: 165-193
• 8 Rivas-Gotz C, Khoury DS, Manolios M et al. Time interval between onset of mitral inflow and onset of early diastolic velocity by tissue Doppler: a novel index of left ventricular relaxation. J Am Coll Cardiol 2003; 42: 1463-1478
• 9 Diwan A, McCulloch M, Lawrie GM et al. Doppler estimation of left ventricular filling pressures in patients with mitral valve disease. Circulation 2005; 111: 3281-3289