简介：Inthecurrenteraofcardiovasculardisease,thediagnosisofheartfailurewithpreservedejectionfraction(HFpEF)isawell-recognizedclinicalentitythatisequallyprevalentbutdistinctlydifferentfromheartfailurewithreducedejectionfraction(HFrEF).DespitenormalEFpatientswiththisdiseasehavesimilarmorbidityandmortalityratescomparedwithHFrEF,aswellasarisingrateofhospitalizations.ThepathophysiologyofHFpEFisincompletelyunderstood.Thenumberoftherapieswithprovenefficacyatimprovinglongtermcardiovascularoutcomesislimited.Womenwithheartfailuresyndromes,particularlytheelderly,aremuchmorelikelytohaveaHFpEFphenotypeatthetimeoftheirdiagnosis.Thepurposeofthispaperistoreviewtheepidemiology,pathophysiology,clinicalfeatures,andcurrentmanagementstrategiesinHFpEF,especiallyasitpertainstowomen.

简介：Heartfailureisacomplexclinicalsyndromethatcanresultfromanystructuralorfunctionalcardiacdisorderthatimpairstheabilityoftheventricletofillwithorejectblood.Theechocardiogramisthesinglemostperformedandusefulstudyinthesepatients.Thisarticlereviewstheroleoftheechocardiogramintheevaluationoftheheartfailurepatient,withoutfocusingontheleftventricle.Thediscussionincludestheuseoftheechocardiogramintheassessmentoftherightventricleanddiastolicfunctionandindetectinghemodynamicandmorphologicchangesinheartfailureoveraperiodoftime.Inaddition,wehighlightsomeofthelimitationsofechocardiographyintheassessmentofthesepatients.

简介：Percutaneouscoronaryintervention(PCI)improvessymptomsandprognosisinischemia-inducing,functionallysignificant,coronarylesions.Useoffractionalflowreserveallowsphysicianstoinvestigatetheischemia-inducingpotentialofaspecificlesionandcanbeusedtoguidecoronaryrevascularization,especiallyinmultivesselcoronaryarterydisease.Fractionalflowreserve-guidedPCIhasbeenextensivelyinvestigated.Resultsshowthatdeferralofstentinginnon-significantlesionsissafe,whereasdeferralofstentinginfunctionallysignificantlesionsworsensoutcome.FFR-guidedPCIimprovesoutcomeinmultivesseldiseaseoverangiography-guidedPCI.Untilrecently,therewaslittleknownaboutthelong-termoutcomeofFFR-guidedrevascularizationanditsvalidityinacutecoronarysyndromes.Thisreviewaimstoaddressthenewevidenceregardinglong-termappropriatenessofFFR-guidedPCI,theneedforhyperemiatoevaluatefunctionalseverity,andtheuseofFFRinacutecoronarysyndromes.

简介：ObjectivesToassesstherelationshipbetweenpeakoxygenconsumption(PVO2)andtheambulationdistanceinsix-minutewalktest(6MWT)amongthehealthysubjects.MethodsThe51healthysubjectswererecruitedforthesix-minutewalktest.Dataofpulmonarygasexchangebreathbybreath,suchasVO2,VCO2werereal-timemeasuredwithwirelessremotesensingK4B2,sotostudytherelationshipbetweenpeakoxygenuptakeandtheambulationdistance.ResultsItwasnoticedthattherewasapositivelinearcorrelationbetweentheambulationdistanceandPVO2(r=0.619,P<0.001)insix-minutewalktest.Theregressionequationwassetup(VO2/kg=0.05D-6.331,P<0.001).PVO2>PVCO2,R<1werefound,whichsuggestedthat6MWTwasatestbelowanaerobicthreshold.ConclusionsTherewasacloselypositivelinearcorrelationbetweentheambulationdistanceandPVO2,whichissafety,convenientandvaluablefortheevaluationofcardiopulmonaryfunctionandthetreatmentofcardiopulmonaryrehabilitation.

简介：Formanyyears,cardiovascularclinicianshavebeenmakingtheargumentthatcompleterevascularizationisthewaytoproceedinpatientswithanyformofischemicheartdisease.Ibelievethatcardiovascularsurgeonsagreewiththisapproachandtrytheirbesttocompletelyrevascularizepatientsatthetimeofcoronaryarterybypassgraftsurgery.AttheUniversityofFlorida,we,likemanyothersintheworld,treatanacutemyocardialinfarctionasanemergency,and,ifthereisSTsegmentelevation,thepatientistransportedimmediatelytothecardiaccatheterizationlaboratoryfromtheemergencydepartment,forrecanalizationoftheculpritartery.

简介：BackgroundTwo-dimensionalspeckletrackingimaging(2D-STI)andreal-timethree-dimensionalechocardiography(RT-3DE)havemoreadvantagesinevaluatingleftventricular(LV)systolicdyssynchronythantraditionalechocardiographictechniques.ThestudyaimedtoevaluateLVdyssynchronyparametersbyboth2D-STIandRT-3DE,andthecorrelationbetweenthesetwotechniques.MethodsAtotalof43chronicheartfailure(CHF)patientsand27healthyvolunteerswereenrolled.Therewere23dyssynchronyparametersselectedtoevaluateleftventricularsystolicsynchronization,involving15from2D-STIand8fromRT-3DE.ResultsFewofthedyssynchronyparametersshowednegativecorrelationswithLVejectionfraction(LVEF)intheCHFgroup.Thedifferencebetweentimetopeak-systolicradialstrainoftheanteroseptalandposteriorsegmentsatthelevelofpapillarymuscles[AS-P(RS)]from2D-STIshowedpositivecorrelationswithpartsoftheparametersfromRT-3DE(P<0.05).ConclusionsLVsystolicdysfunctiondoesnotcorrelatewithdyssynchrony.Moreover,thereisaweakassociationbetween2D-STIandRT-3DEinassessmentofleftventriculardyssynchrony.