Hummel, Yoran M., Liu, Licette C. Y., Lam, Carolyn S. P., Fonseca-Munoz, Daniel F., Damman, Kevin, Rienstra, Michiel, van der Meer, Peter, Rosenkranz, Stephan, van Veldhuisen, Dirk J., Voors, Adriaan A. and Hoendermis, Elke S. (2017). Echocardiographic estimation of left ventricular and pulmonary pressures in patients with heart failure and preserved ejection fraction: a study utilizing simultaneous echocardiography and invasive measurements. Eur. J. Heart Fail., 19 (12). S. 1651 - 1661. HOBOKEN: WILEY. ISSN 1879-0844

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Abstract

Aims Although echocardiography is generally used for the diagnosis of heart failure with preserved ejection fraction (HFpEF), invasive measurements of filling pressures are the gold standard. Studies simultaneously performing echocardiography and invasive measurements in HFpEF are sparse. Methods and results Invasive haemodynamic and echocardiographic measurements were simultaneously performed in 98 patients with heart failure New York Heart Association class >= II, left ventricular ejection fraction (LVEF) >= 45%, and suspected pulmonary hypertension on a previous echocardiogram. Multivariable linear regression analyses were used to establish echocardiographic predictors of pulmonary artery wedge pressure (PAWP), left ventricular end-diastolic pressure (LVEDP), and mean pulmonary arterial pressure (mPAP). Mean age of the study patients was 74 +/- 9 years, 68% were female, mean LVEF was 57 +/- 5%, and 30% had atrial fibrillation at the time of measurement. Mean PAWP, LVEDP and mPAP were 17.2 +/- 6.2, 16.7 +/- 5.8 and 30.9 +/- 10.2 mmHg, respectively. Isovolumetric relaxation time (IVRT) and left atrial reservoir strain could moderately estimate PAWP (r = 0.656; P < 0.001). LVEDP was only modestly predicted by IVRT and right ventricular wall thickness (r = 0.548; P < 0.001). Surprisingly, a low correlation was found between E/e'(mean) and PAWP (r = 0.240; P = 0.019), E/e'(mean) and LVEDP (r = 0.081; P = 0.453). Correlation coefficients were similar in patients with and without atrial fibrillation. Conclusion In patients with HFpEF, echocardiographic measurements, including the E/e' ratio, have a poor to moderate predictive value for the estimation of invasively acquired LVEDP and PAWP. This limitation should be taken into account for the diagnosis and evaluation of patients with HFpEF.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Hummel, Yoran M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Liu, Licette C. Y.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lam, Carolyn S. P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fonseca-Munoz, Daniel F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Damman, KevinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rienstra, MichielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van der Meer, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rosenkranz, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van Veldhuisen, Dirk J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Voors, Adriaan A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hoendermis, Elke S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-208811
DOI: 10.1002/ejhf.957
Journal or Publication Title: Eur. J. Heart Fail.
Volume: 19
Number: 12
Page Range: S. 1651 - 1661
Date: 2017
Publisher: WILEY
Place of Publication: HOBOKEN
ISSN: 1879-0844
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
LEFT ATRIAL FUNCTION; MITRAL ANNULUS VELOCITY; FILLING PRESSURES; DOPPLER-ECHOCARDIOGRAPHY; DIASTOLIC FUNCTION; TISSUE DOPPLER; EUROPEAN ASSOCIATION; AMERICAN SOCIETY; EXERCISE; RECOMMENDATIONSMultiple languages
Cardiac & Cardiovascular SystemsMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/20881

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