Avaliação da influência de alterações cardíacas na ultrassonografia vascular periférica de idosos

Abstract

Background: Heart diseases can cause changes to vascular ultrasonography (VUS) waveforms in peripheral vessels. These changes are typically bilateral and systemic, they have been little studied, and little is known about them. Objective: To assess peripheral VUS waveforms in elderly patients in order to identify changes caused by heart diseases. Methods: During 2014, a total of 183 elderly patients were examined with peripheral VUS and the results were analyzed. Results: The sample comprised 102 women (55.7%) and 81 men (44.3%) with ages ranging from 60 to 91 years (mean of 70.4±7.2 years). Abnormalities were identified in VUS waveforms in 84 patients (45.9%). A total of 138 abnormalities were identified and classified into eight of the 13 categories described in the literature, as follows: arrhythmia, systolic pulsus bisferiens, low peak systolic velocity, pulsatile flow in femoral veins, bradycardia, tachycardia, pulsus tardus et parvus and pulsus alternans. There was low agreement between presence/absence of VUS abnormalities and cardiological assessments. Analysis of specific abnormalities revealed variable levels of agreement between VUS and cardiological assessments, ranging from good for tachycardia, moderate for arrhythmia, to low for bradycardia. There was no agreement between VUS and cardiological examinations for the remaining categories of abnormalities. Conclusions: Certain cardiac abnormalities can be identified in elderly patients by analysis of peripheral VUS waveforms. It is important to recognize and report the presence of these abnormalities because there is a possibility that they may serve to signal hitherto unidentified diagnoses in these patients. However, further studies are needed to determine the importance of changes to peripheral Doppler waveforms to recognition of heart diseases.

Varizes pulsáteis simulando aneurisma de artéria femoral: relato de caso

“… 1 , 6 , 7 In the great majority of cases, the changes caused by cardiac effects on the flow waveforms in peripheral vessels go unrecognized, and even when they are observed, they are rarely noted in the report. 4 …”

“…Na presença de uma junção safeno-femoral incompetente, a “ventricularização” do fluxo do sistema venoso profundo decorrente de uma RT importante pode ser transmitida ao eixo safeno e a varicosidades de membros inferiores 1 , 6 , 7 . As alterações por efeito cardíaco no formato das ondas de fluxo dos vasos periféricos, na grande maioria das vezes, não são reconhecidas, e, quando o são, poucas vezes aparecem relatadas no laudo 4 .…”

“…Although recognition of pulsatility in peripheral veins caused by TR and valve incompetence has been described since 1827, 3 even with current widespread use of Doppler ultrasound, ignorance of the pattern of these changes is reflected in the poor or absent descriptions in examination reports. 4 We report a case of pulsatile varicose veins (PVV) in a patient with TR. The study was submitted to the Ethics Committee (CAAE 36635420.1.0000.50.71) and approved in ruling number 4.426.72.…”

“…Embora o reconhecimento da pulsatilidade em veias periféricas em decorrência de RT e insuficiência valvar venosa esteja descrito desde 1827 3 , nos dias de hoje, mesmo com a ampla utilização do ultrassom Doppler, o desconhecimento do padrão dessas alterações se reflete na descrição pobre ou ausente delas nos laudos dos exames 4 . Relatamos um caso de varizes pulsáteis (VP) em paciente com RT, submetido à apreciação do comitê de ética (CAAE 36635420.1.0000.50.71), aprovado segundo o parecer 4.426.72.…”