Prevalencia de disfunción diastólica por ecocardiograma en hipertensión arterial
Prevalence of ecocardiographic indexes of diastolic disfunction in hypertensive patients Estudio de corte transversal
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La hipertensión arterial a menudo se asocia con disfunción diastólica, que por sí sola es un marcador de riesgo cardiovascular. La ecocardiografía es el método más utilizado y relevante en su diagnóstico. Objetivo: establecer la prevalencia de disfunción diastólica en hipertensos mediante ecocardiografía Doppler (pulsado y tisular). Métodos: estudio de corte transversal. Se realizaron ecocardiogramas transtorácicos basales evaluando las ondas E y A del Doppler pulsado y la onda e del Doppler tisular, en pacientes mayores de quince años con hipertensión arterial que asistieron al servicio de cardiología del Hospital de San José entre marzo y agosto de 2009. Resultados: se evaluaron 115 pacientes, 53% mujeres y 47% hombres, con edad promedio de 66.1 años. Por técnica Doppler pulsado se identificó el 82% de la población hipertensa con disfunción diastólica, la mayoría grado I (74,8%). No se documentó con Doppler tisular. En los casos positivos la frecuencia de diabetes mellitus, tabaquismo y terapia de remplazo renal fue mayor. Conclusiones: la frecuencia de disfunción diastólica por Doppler pulsado es alta en los hipertensos. El diagnóstico requiere el uso de múltiples parámetros y no se debe limitar a las técnicas pulsado y/o tisular.
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1. Ronald.GVíctor, Norman M. Kaplan. Systemic hypertension: mechanisms and diagnosis. Braunwald hea11 disease. 8th ed. Philadelphia: 2008. p. 1027- 48.
2. SchargrodskyH,Hemandez-Hemandez R, ChampagneBM, SilvaH, Vinueza R, SilvaAycaguer LC, et al. CARMELA: assessment of cardiovascular risk in seven Latin American cities. Am J Med. 2008 Jan; 121(]):58-65.
3. Kannel WB. Hypertension: reflections on risks and prognostication. Med Clin N01thAm. 2009 May;93(3): 541-58
4. Staessen JA, Wang J, BianchiG, Birkenhager WH. Essential hypertension. Lancet. 2003 May IO;361(9369):1629-41.
5. Smith M, Drinkovic N, Harrison M, Wisenbaugh T, De Maria A. Doppler evaluation of left ventricular compliance and ventricular filling abnorrnalities. Echocardiography. 1992 Jul;9:407-20.
Tendera M, Wojakowski W. Epidemiology of diastolic heart failure. In: Smiseth OA, Tendera M, editors. Diastolic heart failure . 1st ed. London: Springer;2008. p. 205-12.
7. Leite-MoreiraAF. Current perspectives in diastolic dysfunction and diastolic heart failure. Heart. 2006 May;92(5): 712-8. 4
8. Bella JN, Palmieri V, Roman MJ, Liu JE, Welty TK, Lee ET, et al. Mitral ratio of peak early to late diastolic filling velocity as a predictor of mortality in middle-aged and elderly adults: the strong heart study. Circulation. 2002 Apr 23; 105(16):1928-33.
9. Fischer M, Baessler A, HenseHW, Hengstenberg C, Muscholl M, Holmer S, et al. Prevalence of left ventricular diastolic dysfunction in the community. Results from a Doppler echocardiographic-based survey of a population sample. Eur Heart J. 2003 Feb; 24(4):320-8.
10. Redfield MM, Jacobsen SJ, Burnett JC, Jr., Mahoney DW, Bailey KR, Rodeheffer RJ. Burden of systolic and diastolic ventricular dysfunction in the conununity: appreciating the scope of the heart failure epidemic. JAMA. 2003 Jan 8; 289(2):194-202.
11. Lalande S. Johnson BD. Diastolic dysfunction: a link between hypertension and heart failure. Drugs Today (Barc). 2008 Jul;44(7): 503-13.
12. VennaA, Solomon SD. Diastolic dysfunction as alink between hypertension and heart failure. Med Clin North Am. 2009 May;93(3): 647-64.
13. Periasamy M, Janssen PM. Molecular basis of diastolic dysfunction. Heart Fai1 Clin.2008 Jan;4(1): 13-21.
14. Yamamoto K, Sakata Y, Ohtani T. Takeda Y, Mano T.Heart failure with preserved ejection fraction.Circ J. 2009 Mar;73(3):404-10.
15. Paulus WJ, Tschope C, Sanderson JE, Rusconi C, Flachskampf FA, Rademakers FE, et al. How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with norrnal left ventricular ejection fraction by theHea.tt Failure and EchocardiographyAssociations of theEuropean Society of Cardiology. Eur Heart J. 2007 Oct;28(20):2539-50.
16. Alland L, Klein M, Desai Y. Assessment of diastolic function by echocardiography. In: Otto C, editor.Practice of clinical echocardiography. 3rd ed. Philadelphia: Saunders, Elsevier; 2007. p. 237-61.
17. Aurigemma GP, Gaasch WH. Clinical practice. Diastolic heart failure. N Engl J Med. 2004 Sep 9; 351(11):1097-105.
18. FeigenbaumH, Aimstrong W, Ryan T. Evaluación de lasfunciones sistólica y diastólica del ventrículo izquierdo. En: Feigenbaum ecocardiografía. 6a ed. Madrid, España: Médica Panamericana; 2005. p. 138-79.
19. Lester SJ, Tajik AJ, Nishimura RA, Oh JK, Khandheria BK, Seward JB. Unlocking the mysteries of diastolic function: deciphering the Rosetta Stone 1O years later. J Am Coll Cardiol. 2008 Feb 19; 51(7):679-89.
20. W ierzbowska-Drabik K, Drozdz J, Plewka M, Trzos E, Krzeminska-Pakula M, Kasprzak JD. The utility of pulsed tissue Doppler parameters for the diagnosis of advanced left ventricular diastolicdysfunction. Echocardiography. 2006 Mar; 23(3):189-96.
21 Wang J, Nagueh SF.Curren! perspectives on cardiac function in patients with diastolic heart failure. Circulation. 2009 Mar 3;119(8):1146-57.
22. Thohan V, Patel S. The challenges associated with curren! clinical trials for diastolic heart failure. Curr Opin Cardiol. 2009 May;24(3):230-8.
23. Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, et al. Recommendations for !he evaluation ofleft ventricular diastolic function by echocardiography. JAm Soc Echocardiography. 2009 Feb;22(2):107-33.
24. Bess RL, Khan S, RosmanHS, Cohen GI, Allebban Z, Gardin JM. Technical aspects of diastology: why mitral inflow and tissue Doppler imaging are the prefeITed parameters?. Echocardiography. 2006Apr; 23(4):332-9.
25. Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, et al. 2009 Focused update incorporated into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults AReport of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Developed in Collaboration With the lntemational Society for Heart and Lung Transplantation. JAm Coll Cardiol. 2009 Apr 14;53(15):e l-e90.
26. Third Report of the National Cholesterol EducationProgram(NCEP) Expert Panel on Detection, Evaluation, and Treatment ofHigh Blood Cholesterolin Adults (Adult Treatment Panel III) final report. Circulation. 2002 Dec 17; 106(25):3143-421.
27. Bhatia RS, Tu JV, Lee DS, Austin PC, Fang J, Haouzi A, et al. Outcome of heart failure with preserved ejection fraction in a population-based study. N Engl J Med. 2006 Jul 20;355(3):260-9.
28. Hogg K, Swedberg K,McMurray J. Heart failure with preserved left ventricular systolic function; epidemiology, clinical characteristics, and prognosis. JAm Coll Cardiol. 2004 Feb 4; 43(3):317-27.
29. Owan TE, Hodge DO, Herges RM, Jacobsen SJ, Roger V L, Redfield MM. Trends in prevalence and outcome of heart failure with preserved ejection fraction. N Engl J Med 2006 Jul 20;355(3):251-9.
30. Varela-Roman A,GrigmianL, Barge E, Bassante P, de laPena MG, Gonzalez Juanatey JR. Heart failure in patients with preserved and deteriorated left ventricular ejection fraction. Heart. 2005Apr;91(4):489-94.