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January 1, 2005Circulation JournalOpen Access

Can Transthoracic Doppler Echocardiography Predict the Discrepancy Between Left Ventricular End-Diastolic Pressure and Mean Pulmonary Capillary Wedge Pressure in Patients With Heart Failure?

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Key result

Transthoracic Doppler echocardiography parameters Δd ≥10 ms and E/Ea ≤14 predicted the discrepancy between elevated LVEDP and normal mean PCWP with 100% sensitivity and 85% specificity.

Why the study?

Can transthoracic Doppler echocardiography predict the discrepancy between left ventricular end-diastolic pressure and mean pulmonary capillary wedge pressure in patients with heart failure?

Population

140 consecutive patients with heart disease referred for clinically indicated cardiac catheterization, all…

Comparison

Transthoracic Doppler echocardiography measuring… vs Bilateral-sided cardiac catheterization…

Design

Cross-sectional, All Doppler measurements and calculations were made without…

Authors

YHYasuyuki HadanoYamaguchi University KMKazuya MurataKanazawa University JLJinyao LiuShandong University

Discussion

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Implication

May support noninvasive detection of LVEDP-PCWP discrepancy in HF; leaves open prospective validation before clinical use.

Study Design

Type

Observational (n=140)

Multicenter

No

Structured PICO

Can transthoracic Doppler echocardiography predict the discrepancy between left ventricular end-diastolic pressure and mean pulmonary capillary wedge pressure in patients with heart failure?

P

Population

140 consecutive patients with heart disease referred for clinically indicated cardiac catheterization, all in sinus rhythm with normal PQ interval and no more than mild mitral or aortic regurgitation. Mean age 66±9 years, 68.6% male (96 males, 44 females). LVEF range 20% to 70%.

I

Intervention

Transthoracic Doppler echocardiography (TTDE) measuring Deltad (difference between duration of atrial reversal of pulmonary venous flow and duration of mitral A wave) and E/Ea (ratio of peak early diastolic transmitral flow to tissue Doppler-derived peak early diastolic velocity of mitral annulus)

C

Comparator

Bilateral-sided cardiac catheterization measuring left ventricular end-diastolic pressure (LVEDP) and mean pulmonary capillary wedge pressure (PCWP)

O

Outcome

Diagnostic accuracy (sensitivity and specificity) of Deltad and E/Ea for predicting the discrepancy between elevated LVEDP (>=17 mmHg) and normal mean PCWP (<=12 mmHg)surrogate

Noninvasive transthoracic Doppler echocardiography can accurately predict the discrepancy between elevated LVEDP and normal PCWP, aiding in the early detection of elevated filling pressures in heart failure patients.

Limitations

Simultaneous recordings of LV pressure and PCWP were not performed.
Measurement of the Doppler indexes and of hemodynamics was not performed simultaneously.
Lack of estimation of LA contractility by Doppler parameters to demonstrate increased LA contractility in patients with prolonged PAd.
Simultaneous recordings of LV pressure and PCWP were not performed (echocardiography was recorded within 3 hours before cardiac catheterization)
Estimation of LA contractility was not performed to demonstrate increased LA contractility in patients with prolonged PAd

Cite This Study

Hadano et al. (2005) conducted an observational in Heart failure (n=140). Transthoracic Doppler echocardiography (TTDE) vs. Invasive cardiac catheterization was evaluated on Prediction of elevated LVEDP (≥17 mmHg) and normal mean PCWP (≤12 mmHg) using Δd ≥10 ms and E/Ea ≤14. Transthoracic Doppler echocardiography parameters Δd ≥10 ms and E/Ea ≤14 predicted the discrepancy between elevated LVEDP and normal mean PCWP with 100% sensitivity and 85% specificity.

synapsesocial.com/papers/6a0ea76006ecbe833447a92a https://doi.org/10.1253/circj.69.432

Topics

Heart failure HFrEF treatment Echocardiography

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