Key result
TEE pulmonary vein diastolic wave deceleration time predicts elevated left atrial pressure with ~0.90 AUC.
Why the study?
The study was conducted to correlate the transesophageal echocardiographic deceleration time of pulmonary venous diastolic wave with noninvasively estimated left atrial pressure, and to assess the ease of each method in patients undergoing off-pump CABG.
Does the deceleration time of the pulmonary venous diastolic wave measured by transesophageal echocardiography predict elevated left atrial pressure in patients undergoing off-pump coronary artery bypass grafting?
Observational (n=45)
Does the deceleration time of the pulmonary venous diastolic wave measured by transesophageal echocardiography predict elevated left atrial pressure in patients undergoing off-pump coronary artery bypass grafting?
Transesophageal echocardiographic measurement of pulmonary vein diastolic wave deceleration time is a feasible and accurate noninvasive predictor of elevated left atrial pressure in patients undergoing coronary artery bypass grafting.
Background: The deceleration time of the pulmonary venous diastolic flow has been well-correlated with invasive pulmonary capillary wedge pressure in several studies regardless of left ventricular systolic function. This study was conducted to correlate deceleration time of pulmonary venous diastolic wave, DT(D), and left atrial pressure (LAP), obtained noninvasively from mitral early diastolic inflow velocity-to-early diastolic mitral annulus velocity ratio (E/e′), and to assess the ease of each method in patients with coronary artery disease undergoing off-pump coronary artery bypass grafting (OPCAB) by transesophageal echocardiography. Methods: Forty-five adult patients with coronary artery disease, with left ventricular ejection fraction of ≥50% posted for elective OPCAB were enrolled in the study. Results: Forty values of LAP and DT(D) were analyzed. A significant linear correlation (r = −0.64) was found between DT(D) and LAP. Area under the curve of DT(D) of ≤183 ms for predicting elevated LAP (>15) was 0.903 (95% confidence interval: 0.767 to 0.974, P < 0.0001). Conclusion: Deceleration time of pulmonary venous flow diastolic waveform, DT(D), feasible promising echocardiographic measure in determining elevated LAP and DT(D)≤183 ms predicts elevated LAP.
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Nagaraja et al. (2020) conducted an observational in Coronary artery disease (n=45). Transesophageal echocardiographic evaluation of pulmonary vein diastolic wave deceleration time (DT(D)) vs. Left atrial pressure (LAP) obtained noninvasively from E/e' was evaluated on Prediction of elevated left atrial pressure (>15) (AUC 0.903, 95% CI 0.767 to 0.974, p=< 0.0001). Transesophageal echocardiographic measurement of pulmonary vein diastolic wave deceleration time ≤183 ms predicted elevated left atrial pressure with an AUC of 0.903 (95% CI 0.767-0.974; P<0.0001).
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