What is the feasibility and concordance of measuring multiple systolic and diastolic echocardiographic variables in elderly patients with heart failure symptoms?
The low feasibility and questionable concordance of several diastolic echocardiographic variables in elderly patients with heart failure symptoms suggest that routine measurement of a high number of variables may not be rational.
Objectives: To explore the concordance and the feasibility of obtaining systolic or diastolic variables of left ventricular function in elderly patients with heart failure symptoms. Methods: One hundred twenty four patients with symptoms of heart failure (mean age 77 years, 70% females) were included in a cross-sectional, explorative study. Nineteen echocardiographic variables (7 systolic and 12 diastolic) were measured. Results: Overall, feasibility ranged from 93% to 100% for 15 variables and was 48% for mitral regurgitation dp/dt(MRdp/dt), 66% for the difference between pulmonary AR-dur and mitral A-dur, 81% for the ratio between early and late mitral inflow velocity (E/A), and 76% for tissue Doppler imaging late dia-stolic velocity (TDI A’). Concordance was very good/ good in 83% and poor/missing in 17% of systolic variables, whereas it was very good/good for 67% of diastolic variables and poor/missing for 33%. Factor analysis reduced systolic variables to two factors that explained 69% of the total variance in systolic function. Conclusions: Low feasibility for some and questionable concordance of especially diastolic variables questions the rationale for routinely measuring a high number of echocardigraphic variables. The results of the factor analysis further strengthen the possibility of reducing the number of measured variables. The clinical value of such a reduction needs to be validated.
Remmets et al. (Sun,) studied this question.