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September 1, 2017Echocardiography

Noninvasive assessment of left ventricular end‐diastolic pressure by deceleration time of early diastolic mitral annular velocity in patients with heart failure

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Why the study?

Does the deceleration time of early mitral annular velocity (e'DT) accurately predict elevated left ventricular end-diastolic pressure in patients with heart failure?

Population

94 patients admitted to the hospital for heart failure. Exclusion criteria: atrial fibrillation, mitral…

Comparison

Measurement of deceleration time of early mitral… vs Simultaneous invasive left ventricular…

Design

Cross-sectional

Key result

The deceleration time of early mitral annular velocity (e'DT) predicted LVEDP >16 mm Hg with a significantly greater area under the curve than E/e' (0.91 vs 0.74, P=0.046).

Authors

KTKazushi TakemotoKHKumiko HirataTHTakeshi Hozumi

Discussion

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Overview

e'DT may better estimate elevated LVEDP than E/e' in HF; hypothesis-generating and requires prospective validation.

Study Design

Type

Observational (n=94)

Structured PICO

Does the deceleration time of early mitral annular velocity (e'DT) accurately predict elevated left ventricular end-diastolic pressure in patients with heart failure?

P
Population
94 patients admitted to the hospital for heart failure. Exclusion criteria: atrial fibrillation, mitral valve surgery, and acute coronary syndrome.
I
Intervention
Measurement of deceleration time of early mitral annular velocity (e'DT) by tissue Doppler echocardiography
C
Comparator
Simultaneous invasive left ventricular end-diastolic pressure (LVEDP) measurement (reference standard) and early transmitral flow velocity to early mitral annular velocity ratio (E/e')
O
Outcome
Diagnostic accuracy (Area under the ROC curve) for predicting LVEDP >16 mm Hgsurrogate

Main Result

Absolute Event Rate: 0.91% vs 0.74%

p-value: p=0.046

The deceleration time of early mitral annular velocity (e'DT) is a simple and accurate noninvasive index for estimating LV filling pressure, outperforming E/e', particularly in patients with an intermediate E/e' of 10-14.

Cite This Study

Takemoto et al. (2017) conducted an observational in Heart failure (n=94). Deceleration time of early mitral annular velocity (e'DT) vs. Early transmitral flow velocity (E)/e' was evaluated on Prediction of LVEDP >16 mm Hg (Area under the ROC curve) (p=0.046). The deceleration time of early mitral annular velocity (e'DT) predicted LVEDP >16 mm Hg with a significantly greater area under the curve than E/e' (0.91 vs 0.74, P=0.046).

synapsesocial.com/papers/6a0663413f8bf83a443dda60https://doi.org/10.1111/echo.13626
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