Evaluación de la disfunción diastólica y consideraciones perioperatorias
DOI:
https://doi.org/10.35663/amp.2017.343.406Abstract
Se revisó la importancia del hallazgo de disfunción diastólica en el peri-operatorio como predictor de morbimortalidad debido a eventos cardiovasculares mayores. Se realizó una búsqueda bibliográfica en las bases de datos de PubMed, Cochrane, Scielo, Bireme, Lilacs y Google Scholar. Se revisaron 250 artículos y se seleccionaron 55 que por criterio de los autores están relacionados directamente con el tema. Se observó que gran porcentaje de los pacientes con falla cardiaca tienen función sistólica preservada y que tener disfunción diastólica es un factor de riesgo independiente para presentar eventos cardiovasculares mayores en el perioperatorio. La disfunción diastólica ha demostrado ser un factor de riesgo independiente para eventos cardiovasculares mayores en cirugía no cardiaca. La importancia del uso de la ecocardiografía en el diagnóstico y seguimiento de la disfunción diastólica es cada vez mayor. La disfunción diastólica continúa siendo una entidad subdiagnosticada. El Manejo terapéutico debe ser estrecho y cauteloso evitando las variaciones hemodinámicas bruscas y adelantándose a la hipotensión con las medidas farmacológicas adecuadas y del manejo de líquidos, apoyados en un estricto control perioperatorio con medición de la presión arterial invasiva y ecocardiograma transesofágico.Downloads
References
Cruvinel MGC, Castro CHVd. Disfunção diastólica: sua importância para o anestesiologista. Rev Bras Anestesiol. 2003;53(2):237-47.
Sherazi S, Zareba W. Diastolic heart failure: predictors of mortality. Cardiol J. 2011;18(3):222-32.
Mahmood F, Jainandunsing J, Matyal R. A practical approach to echocardiographic assessment of perioperative diastolic dysfunction. J Cardiothoracic Vasc Anesth. 2012;26(6):1115-23.
Kovács SJ. Diastolic Function in Heart Failure. Clinical Medicine Insights Cardiology. 2015;9(Suppl 1):49-55.
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 normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology. Eur Heart J. 2007;28(20):2539-50.
Inouye I, Massie B, Loge D, Topic N, Silverstein D, Simpson P, et al. Abnormal left ventricular filling: an early finding in mild to moderate systemic hypertension. Am J Cardiol. 1984;53(1):120-6.
Vargas Trujillo C. Disfunción diastólica con anestésicos y cardioprotección con halogenados. Rev Mex Anestesiol. 2012;35(1):46-55.
Magner JJ, Royston D. Heart failure. Br J Anaesth. 2004;93(1):74-85.
Kasner M, Westermann D, Steendijk P, Gaub R, Wilkenshoff U, Weitmann K, et al. Utility of Doppler echocardiography and tissue Doppler imaging in the estimation of diastolic function in heart failure with normal ejection fraction: a comparative Dopplerconductance catheterization study. Circulation. 2007;116(6):637- 47.
Angeja BG, Grossman W. Evaluation and management of diastolic heart failure. Circulation. 2003;107(5):659-63.
Spinale FG, Stolen CM. Biomarkers and Heart Disease: What is Translational Success? J Cardiovasc Transl Res. 2013;6(4):447-8.
Merello LR, Riesle E, Alburquerque J, Torres H, Aranguiz-Santander E, Pedemonte O, et al. Risk scores do not predict high mortality after coronary artery bypass surgery in the presence of diastolic dysfunction. The Ann Thorac Surg. 2008;85(4):1247-55.
Galderisi M. Diastolic dysfunction and diabetic cardiomyopathy: evaluation by Doppler echocardiography. J Am Coll Cardiol. 2006;48(8):1548-51.
Palmiero P, Zito A, Maiello M, Cameli M, Modesti PA, Muiesan ML, et al. Left ventricular diastolic function in hypertension: methodological considerations and clinical implications. J Clin Med Res. 2015;7(3):137-44.
Wan SH, Vogel MW, Chen HH. Pre-clinical diastolic dysfunction. J Am Coll Cardiol. 2014;63(5):407-16.
Marzia R. Heart failure with preserved ejection fraction. J Geriatr Cardiol. 2013;10(4):369-76.
Roscani MG, Matsubara LS, Matsubara BB. Insuficiência cardíaca con fraccion de eyeccion normal. Arq Bras Cardiol. 2010;94(5):694-702.
Asrar Ul Haq M, Mutha V, Rudd N, Hare DL, Wong C. Heart failure with preserved ejection fraction - unwinding the diagnosis mystique. Am J Cardiovasc Dis. 2014;4(3):100-13.
Fernández-Pérez GC, Duarte R, Corral de la Calle M, Calatayud J, Sánchez González J. Análisis de la función diastólica del ventrículo izquierdo mediante resonancia magnética. Radiología. 2012;54(4):295-305.
Tan YT, Wenzelburger F, Lee E, Heatlie G, Leyva F, Patel K, et al. The pathophysiology of heart failure with normal ejection fraction: exercise echocardiography reveals complex abnormalities of both systolic and diastolic ventricular function involving torsion, untwist, and longitudinal motion. J Am Coll Cardiol. 2009;54(1):36-46.
Kalifa J, Jalife J, Zaitsev AV, Bagwe S, Warren M, Moreno J, et al. Intra-atrial pressure increases rate and organization of waves emanating from the superior pulmonary veins during atrial fibrillation. Circulation. 2003;108(6):668-71.
Chang SL, Chen YC, Chen YJ, Wangcharoen W, Lee SH, Lin CI, et al. Mechanoelectrical feedback regulates the arrhythmogenic activity of pulmonary veins. Heart. 2007;93(1):82-8.
Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. J Am Soc Echocardiogr. 2009;22(2):107-33.
Marwick TH, Gillebert TC, Aurigemma G, Chirinos J, Derumeaux G, Galderisi M, et al. Recommendations on the use of echocardiography in adult hypertension: a report from the european association of cardiovascular imaging (EACVI) and the American Society of Echocardiography (ASE). J Am Soc Echocardiogr. 2015;28(7):727-54.
Abhayaratna WP, Marwick TH, Smith WT, Becker NG. Characteristics of left ventricular diastolic dysfunction in the community: an echocardiographic survey. Heart. 2006;92(9):1259-64.
Kass DA, Bronzwaer JG, Paulus WJ. What mechanisms underlie diastolic dysfunction in heart failure? Circ Res. 2004;94(12):1533- 42.
King M, Kingery J, Casey B. Diagnosis and evaluation of heart failure. Am Fam Physician. 2012;85(12):1161-8.
Ayuela JM. Estimación de las presiones de llenado de ventrículo izquierdo por ecocardiografía Doppler en pacientes críticos. Med Intensiva. 2004;28(1):20-5.
Oh JK, Hatle L, Tajik AJ, Little WC. Diastolic Heart Failure Can Be Diagnosed by Comprehensive Two-Dimensional and Doppler Echocardiography. J Am Coll Cardiol. 2006;47(3):500-6.
Dokainish H. Combining tissue Doppler echocardiography and B-type natriuretic peptide in the evaluation of left ventricular filling pressures: Review of the literature and clinical recommendations. Can J Cardiol. 2007;23(12):983-9.
Anavekar NS, Oh JK. Doppler echocardiography: a contemporary review. J Cardiol. 2009;54(3):347-58.
Lupu. S. Left atrium function assessment by echocardiography – physiological and clinical implications. Med Ultrason. 2014;16(2):152-9.
Dokainish H. Left ventricular diastolic function and dysfunction: Central role of echocardiography. Glob Cardiol Sci Pract. 2015;2015:3.
Arques S, Roux E, Luccioni R. Current clinical applications of spectral tissue Doppler echocardiography (E/E’ ratio) as a noninvasive surrogate for left ventricular diastolic pressures in the diagnosis of heart failure with preserved left ventricular systolic function. Cardiovasc Ultrasound. 2007;5:16.
Hadano Y, Murata K, Liu J, Oyama R, Harada N, Okuda S, et al. Can transthoracic Doppler echocardiography predict the discrepancy between left ventricular end-diastolic pressure and mean pulmonary capillary wedge pressure in patients with heart failure? Circ J. 2005;69(4):432-8.
Duncan AE, Alfirevic A, Sessler DI, Popovic ZB, Thomas JD. Perioperative assessment of myocardial deformation. Anesth Analg. 2014;118(3):525-44.
Leong DP, De Pasquale CG, Selvanayagam JB. Heart failure with normal ejection fraction: the complementary roles of echocardiography and CMR imaging. JACC Cardiovasc Imaging. 2010;3(4):409-20.
Chunyan Mea. Quantitative assessment of left ventricular function by 3-dimensional speckle-tracking echocardiography in patients with chronic heart failure a meta-analysis. J Ultrasound Med. 2014;33(2):287-95.
Alsaddique AA, Royse AG, Royse CF, Fouda MA. Management of diastolic heart failure following cardiac surgery. Eur J Cardiothorac Surg. 2009;35(2):241-9.
Billehaug Norum I, Ruddox V, Edvardsen T, Otterstad JE. Diagnostic accuracy of left ventricular longitudinal function by speckle tracking echocardiography to predict significant coronary artery stenosis. A systematic review. BMC Medical Imaging. 2015;15:25.
Fayad A, Ansari MT, Yang H, Ruddy T, Wells GA. Perioperative diastolic dysfunction in patients undergoing noncardiac surgery is an independent risk factor for cardiovascular eventsa systematic review and meta-analysis. Anesthesiology. 2016;125(1):72-91.
Mita N, Kuroda M, Miyoshi S, Saito S. Association of preoperative right and left ventricular diastolic dysfunction with postoperative atrial fibrillation in patients undergoing lung surgery: a prospective observational study. J Cardiothorac Vasc Anesth. 2017;31(2):464-73.
Sanders D, Dudley M, Groban L. Diastolic dysfunction, cardiovascular aging, and the anesthesiologist. Anesthesiol Clin. 2009;27(3):497- 517.
Fayad A, Ansari MT, Yang H, Ruddy T, Wells GA. Perioperative diastolic dysfunction in patients undergoing noncardiac surgery is an independent risk factor for cardiovascular events: a systematic review and meta-analysis. Anesthesiology. 2016;125(1):72-91.
Godfrey GEP, Peck MJE. Diastolic dysfunction in anaesthesia and critical care. BJA Education. 2016;16(9):287-91.
Lalande S, Johnson BD. Diastolic dysfunction: a link between hypertension and heart failure. Drugs Today (Barc). 2008;44(7):503-13.
Davis BR, Piller LB, Cutler JA, Furberg C, Dunn K, Franklin S, et al. Role of diuretics in the prevention of heart failure: the antihypertensive and lipid-lowering treatment to prevent heart attack trial. Circulation. 2006;113(18):2201-10.
Yip GW, Wang M, Wang T, Chan S, Fung JW, Yeung L, et al. The Hong Kong diastolic heart failure study: a randomised controlled trial of diuretics, irbesartan and ramipril on quality of life, exercise capacity, left ventricular global and regional function in heart failure with a normal ejection fraction. Heart. 2008;94(5):573-80.
Desai AS, Lewis EF, Li R, Solomon SD, Assmann SF, Boineau R, et al. Rationale and design of the treatment of preserved cardiac function heart failure with an aldosterone antagonist trial: a randomized, controlled study of spironolactone in patients with symptomatic heart failure and preserved ejection fraction. Am Heart J. 2011;162(6):966-72.e10.
Edelmann F, Wachter R, Schmidt AG, Kraigher-Krainer E, Colantonio C, Kamke W, et al. Effect of spironolactone on diastolic function and exercise capacity in patients with heart failure with preserved ejection fraction: the Aldo-DHF randomized controlled trial. Jama. 2013;309(8):781-91.
Digitalis Investigation Group. The effect of digoxin on mortality and morbidity in patients with heart failure. N Engl J Med. 1997;336(8):525-33.
Bergstrom A, Andersson B, Edner M, Nylander E, Persson H, Dahlstrom U. Effect of carvedilol on diastolic function in patients with diastolic heart failure and preserved systolic function. Results of the Swedish Doppler-echocardiographic study (SWEDIC). Eur J Heart Fail. 2004;6(4):453-61.
Yusuf S, Pfeffer MA, Swedberg K, Granger CB, Held P, McMurray JJ, et al. Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction: the CHARM-preserved trial. Lancet. 2003;362(9386):777-81.
Massie BM, Carson PE, McMurray JJ, Komajda M, McKelvie R, Zile MR, et al. Irbesartan in patients with heart failure and preserved ejection fraction. N Engl J Med. 2008;359(23):2456-67.
Castrini AI, Carubelli V, Lazzarini V, Bonadei I, Lombardi C, Metra M. Serelaxin a novel treatment for acute heart failure. Expert Rev Clin Pharmacol. 2015;8(5):549-57.
Downloads
Published
Issue
Section
License
Esta obra está bajo una Licencia Creative Commons Atribución 4.0 Internacional.
Aquellos autores/as que tengan publicaciones con esta revista, aceptan los términos siguientes:
- Los autores/as conservarán sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación esta revista.
- Los autores/as podrán adoptar otros acuerdos de licencia no exclusiva de distribución de la versión de la obra publicada (p. ej.: depositarla en un archivo telemático institucional o publicarla en un volumen monográfico) siempre que se indique la publicación inicial en esta revista.
- Se permite y recomienda a los autores/as difundir su obra a través de Internet (p. ej.: en archivos telemáticos institucionales o en su página web) antes y durante el proceso de envío, lo cual puede producir intercambios interesantes y aumentar las citas de la obra publicada. (Véase El efecto del acceso abierto).
How to Cite
