Статья
Возможности диастолического стресс-теста при обследовании пациентов перед внесердечными хирургическими вмешательствами
Предоперационная оценка соматического статуса пациента, которому предстоит плановое внесердечное хирургическое вмешательство высокого риска, требует выявления факторов, связанных как с типом хирургического вмешательства, так и с особенностями коморбидного фона каждого пациента. Определение клинически значимых отклонений от нормы эхокардиографических показателей, даже при отсутствии выраженных симптомов, может способствовать изменению тактики ведения или пересмотра запланированных сроков и объемов операции. Аспекты определения эхокардиографических критериев потенциальных осложнений со стороны сердечно-сосудистой системы в послеоперационном периоде, особенно, у малосимптомных пациентов с сохраненной фракцией выброса (ФВ) левого желудочка (ЛЖ), представляют собой важную клиническую проблему. Диастолический стресс-тест — относительно новый вид нагрузочного тестирования — в настоящее время является дополнительным диагностическим инструментом, позволяющим выявить сердечную недостаточность у пациентов без снижения ФВ. Возможность использования этого метода как вспомогательного пособия в оценке риска перед внесердечными хирургическими вмешательствами у пациентов с сохраненной ФВ ЛЖ рассмотрим в этой статье.
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