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April 1, 2022Open Access

Combined E velocity and E/e’ as an estimate of elevated left atrial pressure in patients with atrial fibrillation

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Why the study?

The role of transthoracic echocardiography in assessing diastolic function in patients with atrial fibrillation has not been well characterized.

Does the combination of E velocity and E/e' accurately estimate elevated left atrial pressure in patients with persistent atrial fibrillation?

Population

35 patients with persistent AF and preserved left ventricular ejection fraction undergoing radiofrequency ablation

Comparison

TTE parameters (E and E/e') vs directly measured LAP as reference standard

Design

Prospective observational study

Authors

GMGaigai MaSecond Affiliated Hospital of Xi'an Jiaotong UniversityLFLigang FangUniversity of ViennaXLXue LinBoston University

Discussion

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Implication

E and E/e’ may support noninvasive LAP estimation in AF; hypothesis-generating and requires validation in larger cohorts before clinical adoption.

Structured PICO

Does the combination of E velocity and E/e' accurately estimate elevated left atrial pressure in patients with persistent atrial fibrillation?

P
Population
35 patients with persistent atrial fibrillation and preserved left ventricular ejection fraction who underwent radiofrequency ablation
I
Intervention
Transthoracic echocardiography (TTE) measuring peak velocity of early mitral diastolic inflow velocity (E) and mitral annular velocity (e') within 24 hours before ablation
C
Comparator
Directly measured left atrial pressure (LAP) via trans-septal puncture at the time of catheter ablation (reference standard)
O
Outcome
Diagnostic accuracy (sensitivity and specificity) of E and E/e' to predict mean LAP >12mmHgsurrogate

In patients with persistent atrial fibrillation and preserved LVEF, combining E velocity and E/e' provides high sensitivity and specificity for detecting elevated left atrial pressure.

Cite This Study

Ma et al. (2022) studied this question.

synapsesocial.com/papers/6a6ff6bf5d37378ac1dd04c3https://doi.org/10.21203/rs.3.rs-1484689/v1
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Measurement of Left Atrial Pressure is a Good Predictor of Freedom From Atrial Fibrillation2014 · 15 citations
  2. 2Comparative tissue Doppler and catheterization study for assessing left ventricular diastolic dysfunction2013 · 1 citations
  3. 3Doppler Estimation of Left Ventricular Filling Pressure in Sinus Tachycardia1998 · 596 citations
  4. 4Doppler Tissue Imaging: A Noninvasive Technique for Evaluation of Left Ventricular Relaxation and Estimation of Filling Pressures1997 · 3,041 citations
  5. 5Pulmonary venous flow velocities recorded by transthoracic Doppler ultrasound: Relation to left ventricular diastolic pressures1993 · 625 citations