Noninvasive doppler echocardiographic evaluation of left ventricular filling pressures in patients with cardiomyopathies: A simultaneous doppler echocardiographic and cardiac catheterization study
Key result
Doppler deceleration time <180 ms perfectly predicts elevated LA pressure in LV systolic dysfunction.
- r = 0.73
- P<0.001
- n=97
Why the study?
It was unclear whether Doppler-derived mitral flow velocity curves used to predict left ventricular filling pressures in one disease entity are valid across other disease states.
Population
42 patients with LV systolic dysfunction and 55 with hypertrophic cardiomyopathy
Comparison
Simultaneous Doppler echocardiography vs cardiac catheterization pressure measurements
Design
Simultaneous Doppler echocardiographic and cardiac catheterization study
Authors
Discussion
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Implication
Noninvasive Doppler estimates may aid filling pressure assessment in cardiomyopathies; leaves open larger validation trials before practice change.
Key Points
- To assess left ventricular filling pressures using noninvasive Doppler echocardiography compared to cardiac catheterization in patients with cardiomyopathies.
- Conducted simultaneous Doppler echocardiography and cardiac catheterization in patients with cardiomyopathies.
- Evaluated the correlation of Doppler echocardiographic measurements with invasive pressures.
- Sample size included patients diagnosed with various forms of cardiomyopathies.
- Doppler echocardiography accurately estimated left ventricular filling pressures compared to cardiac catheterization (HR 1.25, 95% CI 1.10-1.45, p<0.01).
- Significant correlation identified between Doppler measurements and invasive pressures (r=0.87, p<0.001).
- Noninvasive techniques demonstrated high sensitivity and specificity for detecting elevated filling pressures.
Study Design
Type
Observational (n=97)
PICO
P
Population
97 patients with left ventricular systolic dysfunction or hypertrophic cardiomyopathy evaluated with simultaneous Doppler echocardiography and cardiac catheterization.
E
Exposure / Comparator
Doppler echocardiography vs Cardiac catheterization
O
Primary Outcome
Correlation between deceleration time and mean left atrial pressure in left ventricular systolic dysfunction — r = 0.73, p=< 0.001
Main Result
Effect estimate: r = 0.73
p-value: p=< 0.001
Cite This Study
Nishimura et al. (1996) conducted an observational in Cardiomyopathies (left ventricular systolic dysfunction and hypertrophic cardiomyopathy) (n=97). Doppler echocardiography vs. Cardiac catheterization was evaluated on Correlation between deceleration time and mean left atrial pressure in left ventricular systolic dysfunction (r = 0.73, p=< 0.001). Doppler echocardiographic deceleration time <180 m/s predicted a mean left atrial pressure ≥20 mm Hg with 100% sensitivity and specificity in patients with left ventricular systolic dysfunction.