What is the clinical evidence from this study?

Study design: Observational. Population: Diastolic dysfunction (n=235). Intervention: Left ventricular ejection time index (LVETI) vs. Normal controls. Primary outcome: Left ventricular ejection time index (LVETI) to differentiate definite diastolic dysfunction from normal controls (AUC 0.81, 95% CI 0.72 to 0.89, p=<0.0001).

What does this research mean for the field?

Left ventricular ejection time index (LVETI) and arterial wave reflections are significantly increased in patients with diastolic dysfunction, and LVETI accurately detects the condition with an AUC of 0.81. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

May 18, 2006HeartOpen Access

Prolonged mechanical systole and increased arterial wave reflections in diastolic dysfunction

Q: What are the key findings of this study?

Left ventricular ejection time index was significantly prolonged in patients with definite diastolic dysfunction compared to normal controls and accurately detected the condition with an AUC of 0.81.

Q: What does this research mean for the field?

Left ventricular ejection time index (LVETI) and arterial wave reflections are significantly increased in patients with diastolic dysfunction, and LVETI accurately detects the condition with an AUC of 0.81. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

Left ventricular ejection time index was significantly prolonged in patients with definite diastolic dysfunction compared to normal controls and accurately detected the condition with an AUC of 0.81.

Why the study?

Does non-invasive assessment of left ventricular ejection time index (LVETI) and augmented pressure (AP) accurately detect diastolic dysfunction in patients with preserved ejection fraction?

Population

235 consecutive patients undergoing left heart catheterisation for suspected coronary artery disease with…

Comparison

Non-invasive assessment of left ventricular… vs Comparison across three groups based on left…

Design

Cohort, All pressure tracings were checked manually by one experienced senior…

Authors

TWTobias WeberNorthumbria University JAJames E. AuerChildren's Hospital of Wisconsin MOM. F. OʼRourkeVictor Chang Cardiac Research Institute

Discussion

Member takes

Implication

LVETI may aid non-invasive diastolic dysfunction detection in preserved EF; hypothesis-generating and requires prospective validation.

Study Design

Type

Observational (n=235)

Multicenter

Structured PICO

Does non-invasive assessment of left ventricular ejection time index (LVETI) and augmented pressure (AP) accurately detect diastolic dysfunction in patients with preserved ejection fraction?

Population

235 consecutive patients undergoing left heart catheterisation for suspected coronary artery disease (CAD) with preserved systolic function (ejection fraction > 50%), stable clinical condition, and sinus rhythm. Excluded: more than mild valvular dysfunction, pericardial or congenital heart disease. Conducted in a tertiary referral hospital in Austria.

Intervention

Non-invasive assessment of left ventricular ejection time index (LVETI) and arterial wave reflections (augmented pressure [AP]) using radial applanation tonometry.

Comparator

Comparison across three groups based on left ventricular end diastolic pressure (LVEDP) and NT-proBNP levels: definite diastolic dysfunction (DD) (n=44), possible DD (n=109), and normal controls with no DD (n=82).

Outcome

Differences in LVETI and AP across diastolic dysfunction groups, and the diagnostic accuracy (Area Under the Curve) of LVETI and AP to differentiate definite diastolic dysfunction from normal controls.surrogate

Main Result

Effect estimate: AUC 0.81 (95% CI 0.72 to 0.89)

Absolute Event Rate: 433.6% vs 414.3%

p-value: p=<0.0001

Non-invasive measurement of prolonged mechanical systole (LVETI) and increased arterial wave reflections (AP) provides independent diagnostic value for identifying diastolic dysfunction in patients with preserved ejection fraction.

Limitations

Observational nature of the study cannot establish cause and effect
Highly selected patient population due to requirement for cardiac catheterization
Exclusion of patients with atrial fibrillation limits generalizability
Subgroup analysis in symptomatic patients had small numbers and requires confirmation

Cite This Study

Weber et al. (2006) conducted an observational in Diastolic dysfunction (n=235). Left ventricular ejection time index (LVETI) vs. Normal controls was evaluated on Left ventricular ejection time index (LVETI) to differentiate definite diastolic dysfunction from normal controls (AUC 0.81, 95% CI 0.72 to 0.89, p=<0.0001). Left ventricular ejection time index was significantly prolonged in patients with definite diastolic dysfunction compared to normal controls and accurately detected the condition with an AUC of 0.81.

synapsesocial.com/papers/6a1736635498a92aabbdec28 https://doi.org/10.1136/hrt.2005.084145

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Prolonged mechanical systole and increased arterial wave reflections in diastolic dysfunction

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Prolonged mechanical systole and increased arterial wave reflections in diastolic dysfunction

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider