A PEP/LVET ratio > 0.43 measured by pulsed Doppler echocardiography detected LVEF < 35% with an area under the curve of 0.91, 87% sensitivity, and 84% specificity.
Observational (n=177)
Sí
Do systolic time intervals (PEP/LVET ratio) accurately correlate with left ventricular ejection fraction and longitudinal strain in heart failure patients?
Systolic time intervals, specifically the PEP/LVET ratio, offer a simple, highly reproducible, and accurate echocardiographic method to detect reduced left ventricular ejection fraction in heart failure patients.
Estimación del efecto: AUC 0.91
AIMS: Conventionally, the evaluation of left ventricular (LV) systolic function is based on ejection fraction assessment, which may be supplemented by other echocardiographic techniques, such as tissue Doppler imaging, 3D evaluation, and speckle tracking strains. However, these imaging modalities have a high technicity and are time-consuming, while being associated with reproducibility limitations. In this context, the usefulness of simpler measurements such as systolic time intervals (STI) by pulsed Doppler echocardiography must be emphasized. METHODS AND RESULTS: In this multicentre study, left ventricular ejection fraction (LVEF), dP/dt(max), LV stroke volume, myocardial longitudinal deformation, aortic pre-ejectional period (PEP, ms), and left ventricular ejection time (LVET, ms) were prospectively investigated and compared in 134 consecutive heart failure (HF) patients and 43 control subjects. Feasibility of STI measurements was 100%. Intra-observer reproducibility was 98% for PEP, 96% for LVET, 87% for LVEF, and 93% for global longitudinal strain (GLS). By subgroup analyses, with increasingly altered LVEF or GLS, PEP significantly increased, whereas significantly LVET decreased, resulting in a significantly increased PEP/LVET ratio (P 0.43, which allowed us to detect LVEF < 35% with a sensitivity of 87%, and a specificity of 84%. CONCLUSION: STI can be easily and accurately measured in clinical practice, and may be used for detecting alterations in LV systolic function. Moreover, this method is likely to have potential applications in the management of HF patients.
Réant et al. (Mon,) conducted a observational in Heart failure (n=177). Systolic time intervals (PEP/LVET ratio) vs. Left ventricular ejection fraction (LVEF) was evaluated on Detection of LVEF < 35% using PEP/LVET > 0.43 (AUC 0.91). A PEP/LVET ratio > 0.43 measured by pulsed Doppler echocardiography detected LVEF < 35% with an area under the curve of 0.91, 87% sensitivity, and 84% specificity.