Does Doppler echocardiography accurately assess hemodynamics compared to invasive measurement in patients with decompensated systolic heart failure?
Doppler echocardiography provides a reliable, noninvasive alternative to invasive hemodynamic assessment in patients with decompensated systolic heart failure.
BACKGROUND: Doppler echocardiography is currently applied for the assessment of left ventricular and right ventricular hemodynamics in patients with cardiovascular disease. However, there are conflicting reports about its accuracy in patients with unstable decompensated heart failure. The objective of this study was to evaluate the accuracy of the technique in patients with unstable heart failure. METHODS AND RESULTS: Consecutive patients with decompensated heart failure had simultaneous assessment of left ventricular and right ventricular hemodynamics invasively and by Doppler echocardiography. In 79 patients, the noninvasive measurements of stroke volume (r=0.83, P15 mm Hg (area under the curve, 0.86 to 0.92). The recent American Society of Echocardiography/European Association of Echocardiography guidelines were highly accurate (sensitivity, 98%; specificity, 91%) in identifying patients with increased wedge pressure. In 12 repeat studies, Doppler echocardiography readily detected the changes in mean wedge pressure (r=0.75, P=0.005) as well as changes in pulmonary artery systolic pressure and mean right atrial pressure. CONCLUSIONS: Doppler echocardiography provides reliable assessment of right and left ventricular hemodynamics in patients with decompensated heart failure.
Nagueh et al. (Mon,) studied this question.
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