June 22, 2015Cardiovascular UltrasoundOpen Access

Grading diastolic function by echocardiography: hemodynamic validation of existing guidelines

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Why the study?

Does echocardiographic grading of diastolic dysfunction accurately reflect invasive hemodynamic abnormalities in patients undergoing left heart catheterization?

Structured PICO

Does echocardiographic grading of diastolic dysfunction accurately reflect invasive hemodynamic abnormalities in patients undergoing left heart catheterization?

Population

460 consecutive patients who underwent transthoracic echocardiography within 24 h of elective left heart catheterization, with normal sinus rhythm, no confounding structural heart disease, no change in medications between catheterization and echo, and complete echocardiographic data.

Intervention

Echocardiographic grading of diastolic dysfunction (normal, grade 1, grade 2, grade 3)

Comparator

Invasive hemodynamic measurements (Tau, LVEDP, EDVi20) obtained via left heart catheterization

Outcome

Relationship between echocardiographic diastolic dysfunction grade and invasive hemodynamic abnormalities (Tau, LVEDP, EDVi20)surrogate

Echocardiographic grading of diastolic dysfunction has only a modest relationship with invasive hemodynamics, challenging the current paradigm of diastolic function progression.

Limitations

Echo images and catheterization tracings were not obtained simultaneously (within 24h)
Semi-invasive estimate of Tau used instead of high-fidelity pressure measurements
Static stiffness not measured directly; relied on LVEDP and calculated EDVi20
Large percentage of cases excluded, resulting in a select group
Potential misclassification of DD grade based on echocardiographic data

Discussion

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Implication

Echocardiographic DD grading correlates only modestly with invasive hemodynamics; leaves open its accuracy independent of LV systolic dysfunction.

Cite This Study

Grant et al. (2015) studied this question.

synapsesocial.com/papers/6a20216e6ed993cb49fbed37 https://doi.org/10.1186/s12947-015-0023-6

Topics

Echocardiography

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Implication

Echocardiographic DD grading correlates only modestly with invasive hemodynamics; leaves open its accuracy independent of LV systolic dysfunction.

Grading diastolic function by echocardiography: hemodynamic validation of existing guidelines

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Topics

Grading diastolic function by echocardiography: hemodynamic validation of existing guidelines

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider