May 4, 2004Circulation
Optimal Noninvasive Assessment of Left Ventricular Filling Pressures
Key result
Mitral E/Ea correlated better with pulmonary capillary wedge pressure than BNP (r=0.69 vs r=0.32) and provided higher specificity (88% vs 56%) for predicting PCWP >15 mm Hg in ICU patients.
Why the study?
Does mitral E/Ea or BNP better predict PCWP >15 mm Hg in intensive care patients?
Population
50 patients admitted to intensive care (36 with cardiac disease)
Comparison
Simultaneous tissue Doppler echocardiography and… vs Invasive pulmonary capillary wedge pressure…
Design
Cohort
Follow-up
48 hours
Authors
Discussion
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Implication
May aid noninvasive filling pressure assessment in cardiac ICU patients; hypothesis-generating pending prospective validation.
Study Design
Type
Observational (n=50)
Structured PICO
Does mitral E/Ea or BNP better predict PCWP >15 mm Hg in intensive care patients?
P
Population
50 patients admitted to intensive care (36 with cardiac disease)
I
Intervention
Simultaneous tissue Doppler echocardiography (mitral E/Ea) and B-type natriuretic peptide (BNP) measurement
C
Comparator
Invasive pulmonary capillary wedge pressure (PCWP) determination
O
Outcome
Prediction of PCWP >15 mm Hgsurrogate
Main Result
Effect estimate: r=0.69 (E/Ea) vs r=0.32 (BNP)
p-value: p=<0.001
In intensive care patients, mitral E/Ea correlates better with PCWP and is more specific than BNP for predicting elevated left ventricular filling pressures, particularly in those with cardiac disease.
Cite This Study
Dokainish et al. (2004) conducted an observational in Intensive care unit patients (n=50). Mitral E/Ea vs. B-type natriuretic peptide (BNP) was evaluated on Correlation with pulmonary capillary wedge pressure (PCWP) and prediction of PCWP >15 mm Hg (r=0.69 (E/Ea) vs r=0.32 (BNP), p=<0.001). Mitral E/Ea correlated better with pulmonary capillary wedge pressure than BNP (r=0.69 vs r=0.32) and provided higher specificity (88% vs 56%) for predicting PCWP >15 mm Hg in ICU patients.