October 1, 2011The Anatolian Journal of CardiologyOpen Access

Diagnostic accuracy and clinical utility of echocardiographic indices for detecting left ventricular diastolic dysfunction in patients with coronary artery disease and normal ejection fraction

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Coronary artery disease with normal ejection fraction (n=45). Intervention: Echocardiographic indices (septal E/e' and LAVI) vs. Invasive left ventricular end-diastolic pressure (LVEDP ≤16 mmHg). Primary outcome: Prediction of elevated left ventricular end-diastolic pressure (LVEDP >16 mmHg) (AUC 0.694, p=0.01).

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Why the study?

Do echocardiographic indices accurately detect increased left ventricular end-diastolic pressure in patients with coronary artery disease and normal ejection fraction?

Population

45 consecutive patients with coronary artery disease and normal ejection fraction referred for cardiac…

Comparison

Transthoracic echocardiography and tissue… vs Invasive measurement of left ventricular…

Design

Cross-sectional, Echocardiographic analysis blinded to hemodynamic data

Key result

Septal E/e' and left atrial volume index (LAVI) were the best echocardiographic predictors of elevated left ventricular end-diastolic pressure, with AUCs of 0.694 and 0.669, respectively.

Authors

SOSercan Okutucu AKAlper Kepez HAHakan Aksoy

Discussion

Member takes

Overview

Septal E/e' and LAVI show modest accuracy for elevated LVEDP; leaves open their clinical utility in CAD with preserved EF.

Study Design

Type

Cross-Sectional (n=45)

Blinding

Single-blind (echocardiographic analysis blinded to hemodynamic data)

Multicenter

Structured PICO

Do echocardiographic indices accurately detect increased left ventricular end-diastolic pressure in patients with coronary artery disease and normal ejection fraction?

Population

45 patients with coronary artery disease and normal ejection fraction undergoing cardiac catheterization were evaluated to assess the diagnostic accuracy of echocardiographic indices for detecting elevated left ventricular end-diastolic pressure.

Exposure

Transthoracic echocardiography and tissue Doppler imaging (specifically evaluating left atrial volume index [LAVI] and septal E/e' ratio)

Comparator

Invasive measurement of left ventricular end-diastolic pressure (LVEDP) via left heart catheterization (reference standard)

Outcome

Diagnostic accuracy (sensitivity, specificity, AUC) of echocardiographic indices for detecting increased LVEDP (>16 mmHg)surrogate

Main Result

Effect estimate: AUC 0.694

p-value: p=0.01

The combination of left atrial volume index and septal E/e' provides a highly sensitive non-invasive method for detecting elevated left ventricular end-diastolic pressure in patients with coronary artery disease and normal ejection fraction.

Limitations

Relatively small number of patients
Single center experience
Lack of a healthy control group
Onsets of mitral inflow and mitral annulus velocities could not be compared during the same cardiac cycle
Right heart catheterization was not performed
Echocardiographic and hemodynamic evaluations were not performed at the exact same time
smaller study population

Cite This Study

Okutucu et al. (2011) conducted a cross-sectional in Coronary artery disease with normal ejection fraction (n=45). Echocardiographic indices (septal E/e' and LAVI) vs. Invasive left ventricular end-diastolic pressure (LVEDP ≤16 mmHg) was evaluated on Prediction of elevated left ventricular end-diastolic pressure (LVEDP >16 mmHg) (AUC 0.694, p=0.01). Septal E/e' and left atrial volume index (LAVI) were the best echocardiographic predictors of elevated left ventricular end-diastolic pressure, with AUCs of 0.694 and 0.669, respectively.

synapsesocial.com/papers/6a99c624f0ee008393f17f4e https://doi.org/10.5152/akd.2011.186

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October 1, 2011The Anatolian Journal of CardiologyOpen Access

Diagnostic accuracy and clinical utility of echocardiographic indices for detecting left ventricular diastolic dysfunction in patients with coronary artery disease and normal ejection fraction

View Full Paper

Ask AI

Bookmark

Why the study?

Do echocardiographic indices accurately detect increased left ventricular end-diastolic pressure in patients with coronary artery disease and normal ejection fraction?

Population

45 consecutive patients with coronary artery disease and normal ejection fraction referred for cardiac…

Comparison

Transthoracic echocardiography and tissue… vs Invasive measurement of left ventricular…

Design

Cross-sectional, Echocardiographic analysis blinded to hemodynamic data

Key result

Septal E/e' and left atrial volume index (LAVI) were the best echocardiographic predictors of elevated left ventricular end-diastolic pressure, with AUCs of 0.694 and 0.669, respectively.

Authors

SOSercan Okutucu AKAlper Kepez HAHakan Aksoy

Discussion

Member takes

Overview

Septal E/e' and LAVI show modest accuracy for elevated LVEDP; leaves open their clinical utility in CAD with preserved EF.

Study Design

Type

Cross-Sectional (n=45)

Blinding

Single-blind (echocardiographic analysis blinded to hemodynamic data)

Multicenter

Structured PICO

Do echocardiographic indices accurately detect increased left ventricular end-diastolic pressure in patients with coronary artery disease and normal ejection fraction?

Population

Exposure

Transthoracic echocardiography and tissue Doppler imaging (specifically evaluating left atrial volume index [LAVI] and septal E/e' ratio)

Comparator

Invasive measurement of left ventricular end-diastolic pressure (LVEDP) via left heart catheterization (reference standard)

Outcome

Diagnostic accuracy (sensitivity, specificity, AUC) of echocardiographic indices for detecting increased LVEDP (>16 mmHg)surrogate

Main Result

Effect estimate: AUC 0.694

p-value: p=0.01

Limitations

Relatively small number of patients
Single center experience
Lack of a healthy control group
Onsets of mitral inflow and mitral annulus velocities could not be compared during the same cardiac cycle
Right heart catheterization was not performed
Echocardiographic and hemodynamic evaluations were not performed at the exact same time
smaller study population

Cite This Study

synapsesocial.com/papers/6a99c624f0ee008393f17f4e https://doi.org/10.5152/akd.2011.186

Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

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