segunda-feira, 20 de junho de 2016
Video-Aula ASE Guidelines Função Diastólica
E aqui, para ajudar na resolução das questões, a vídeo-aula do ASE sobre o Guidelines de Função Diastólica, publicado há 9 dias atrás no ASE360. Aula obrigatória!!
Questões ASE University - Guidelines Função Diastólica 2016 - Questão 4
4. The diagnosis of diastolic dysfunction in the presence of normal LVEF may be difficult in the setting of significant overlap between Doppler indices in healthy individuals, and normal changes with aging. Which of the following considerations in evaluating diastolic function should be taken into account when assessing diastolic function?
a. Mitral E/A ratio and e’ velocity are age-independent and may be used in the young and elderly to assess diastolic dysfunction.
b. Estimates of pulmonary artery systolic pressure may be age-dependent.
c. The difference in duration between pulmonary vein Ar velocity and mitral A velocity age-dependent.
d. Changes in mitral inflow velocities with Valsalva maneuver may be useful in any age range.
e. All of the above.
a. Mitral E/A ratio and e’ velocity are age-independent and may be used in the young and elderly to assess diastolic dysfunction.
b. Estimates of pulmonary artery systolic pressure may be age-dependent.
c. The difference in duration between pulmonary vein Ar velocity and mitral A velocity age-dependent.
d. Changes in mitral inflow velocities with Valsalva maneuver may be useful in any age range.
e. All of the above.
Questões ASE University - Guidelines Função Diastólica 2016 - Questão 3
3. When performing measurements for assessing diastolic function, which of the following technical acquisition methods should not be used?
a. To accurately measure mitral E and A waves, a low wall filter setting (100–200 MHz) and low signal gain should be used to optimize spectral waveforms without spikes or feathering.
b. To accurately analyze pulsed-wave tissue Doppler velocities of the mitral annulus, the ultrasound system presets for wall filter (low) and lowest signal gain should be used with the sample volume placed at the annulus.
c. To record changes in mitral E and A velocities with Valsalva maneuver, the spectral Doppler recording should be obtained continuously through peak inspiration and as patient performs forced expiration for 10 sec with mouth and nose closed, as well as during release.
d. To measure left atrial volume index, the method of disks or area-length method are used, making sure to include LA appendage or pulmonary veins in the LA.
e. To analyze pulmonary vein inflow velocities, the peak modal velocity at the leading edge of the spectral waveform should be measured.
a. To accurately measure mitral E and A waves, a low wall filter setting (100–200 MHz) and low signal gain should be used to optimize spectral waveforms without spikes or feathering.
b. To accurately analyze pulsed-wave tissue Doppler velocities of the mitral annulus, the ultrasound system presets for wall filter (low) and lowest signal gain should be used with the sample volume placed at the annulus.
c. To record changes in mitral E and A velocities with Valsalva maneuver, the spectral Doppler recording should be obtained continuously through peak inspiration and as patient performs forced expiration for 10 sec with mouth and nose closed, as well as during release.
d. To measure left atrial volume index, the method of disks or area-length method are used, making sure to include LA appendage or pulmonary veins in the LA.
e. To analyze pulmonary vein inflow velocities, the peak modal velocity at the leading edge of the spectral waveform should be measured.
Questões ASE University - Guidelines Função Diastólica 2016 - Questão 2
2. Echocardiographic parameters (both 2D and Doppler) can estimate increases in LVEDP and PCWP. Which of the following statements is true?
a. Mitral E-velocity and the E/A ratio correlate with LVEDP.
b. Mitral A-velocity and A-wave duration correlate with mean PCWP.
c. Pulmonary vein peak Ar velocity and Ar-A duration correlate with LVEDP.
d. Tissue Doppler-derived mitral annular a’ velocity correlates with PCWP.
e. All of the above.
a. Mitral E-velocity and the E/A ratio correlate with LVEDP.
b. Mitral A-velocity and A-wave duration correlate with mean PCWP.
c. Pulmonary vein peak Ar velocity and Ar-A duration correlate with LVEDP.
d. Tissue Doppler-derived mitral annular a’ velocity correlates with PCWP.
e. All of the above.
Questões ASE University - Guidelines Função Diastólica 2016
Mais uma contribuição do amigo Issam. Vou postar em sequência ao longo dos próximos dias, algumas questões sobre o Guidelines de Função Diastólica publicado recentemente pelo ASE. Diga sua resposta certa! em 48h o comentário da questão publicado pelo ASE!
1. Before applying the guidelines, it is essential to consider what the term LV filling pressures refers to. Which of the following statements is true?
a. The term LV filling pressure refers to mean pulmonary capillary wedge pressure (PCWP).
b. The term LV filling pressure refers to the mean left atrial pressure (LAP).
c. The term LV filling pressure refers to the LV pre-A pressure.
d. The term LV filling pressure refers to the LV end-diastolic pressure (LVEDP).
e. All of the above
1. Before applying the guidelines, it is essential to consider what the term LV filling pressures refers to. Which of the following statements is true?
a. The term LV filling pressure refers to mean pulmonary capillary wedge pressure (PCWP).
b. The term LV filling pressure refers to the mean left atrial pressure (LAP).
c. The term LV filling pressure refers to the LV pre-A pressure.
d. The term LV filling pressure refers to the LV end-diastolic pressure (LVEDP).
e. All of the above
sábado, 18 de junho de 2016
Preditores e Desfechos do Mismatch Paciente-Prótese
Estudo do JACC imaging avaliando os preditores e os desfechos relacionados ao mismatch paciente-prótese em paciente submetidos a troca valvar aórtica. (O link para o artigo você encontra aqui).
Strain Regional de VE na Doença de Chagas
Artigo brasileiro, publicado no JASE, sobre alterações no strain regional do VE em paciente com doença de Chagas e função sistólica preservada. Seria o Strain regional tão valoroso quanto a alteração fibrótica da RNM? (o link para o artigo você encontra aqui).
Eventos Cardíacos Adversos em Pacientes com Relaxamento Alterado
Interessante artigo do JASE sugerindo aumento da mortalidade por IC ou por todas as causas em pacientes com HVE e/ou aumento das pressões de enchimento naqueles pacientes com disfunção diastólica grau I. O que os colegas acham? Será preciso reclassificar alguns pacientes com disfunção grau I em grau II? Comentem! (o link para o artigo você encontra aqui).
Assinar:
Postagens (Atom)