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首页> 外文期刊>Journal of Clinical Medicine Research >Utilization of Ultrasound to Assess Volume Status in Heart Failure
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Utilization of Ultrasound to Assess Volume Status in Heart Failure

机译：利用超声评估心力衰竭的体积状态

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Heart failure (HF) represents a significant financial burden to the US health care system, affecting approximately 5.7 million Americans. By 2030, the prevalence of HF is expected to increase by 23%. Clinicians generally evaluate volume status in patients with HF by visualizing jugular venous distension to estimate right atrial pressure; a method with an estimated accuracy of only 50%. Currently, the only endorsed methods for acute HF diagnosis in the 2017 American College of Cardiology (ACC) guidelines are brain natriuretic peptide (BNP) or N-terminal pro-B-type natriuretic peptide (NT-proBNP), pre-discharge BNP or NT-proBNP, and myocardial fibrosis markers. However, serial testing of BNP to monitor therapy remains controversial. Moreover, an elevated BNP cannot be attributed solely to a cardiac cause. Given the limitations of the current methods, a robust tool is needed to reliably assess volume status in HF patients. It is now known that hemodynamic congestion from increases in intracardiac pressure occurs days to weeks prior to the onset of typical HF symptoms, such as weight gain and shortness of breath. It has been postulated that assessing the inferior vena cava (IVC) diameter with a portable ultrasound, may be the simple, reliable, and cost-effective method of evaluating right atrial pressure, and thus, the severity of HF. Given this exciting new tool in assessing volume status in patients with HF, we pose the question of whether this imaging modality can be used to risk-stratify patients and guide management. The aim of this paper is to highlight the many benefits of portable ultrasound in assessing volume status in this population, and to discuss whether this imaging modality can help guide physicians in the management of their HF patients.Copyright 2020, Khan et al.
机译：心力衰竭（HF）代表了美国医疗保健系统的重大财务负担，影响了约570万美国人。到2030年，预计HF的患病率将增加23％。临床医生通常通过可视化颈静脉扩散来评估HF患者的体积状态以估计右心房压力;估计精度仅为50％的方法。目前，2017年美国心脏病学（ACC）指南的急性HF诊断唯一的认可方法是脑利钠肽（BNP）或N-末端Pro-B型利钠肽（NT-probNP），预放电BNP或nt-probnp和心肌纤维化标记物。然而，BNP对监测治疗的连续测试仍然存在争议。此外，升高的BNP不能仅仅归因于心脏病。鉴于当前方法的局限性，需要一种强大的工具来可靠地评估HF患者中的体积状态。现在已知从典型的HF症状发作前几天到几天到几周内的血液动力学充血，例如重量增加和呼吸急促。已经假定了评估具有便携式超声的下腔静脉（IVC）直径，可以是评估右心房压力的简单，可靠和经济高效的方法，从而进行HF的严重程度。鉴于这种激动人心的新工具在评估HF患者的患者中的体积状态方面，我们提出了这个成像模型是否可用于风险 - 分层患者和指导管理的问题。本文的目的是突出便携式超声在评估本人的体积状态方面的许多好处，并讨论此成像模型是否可以帮助导致医生在其HF患者的管理中。2020年，Khan等人。

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