E/e' ratio is superior to speckle tracking for detecting elevated left ventricular end‐diastolic pressure in patients with coronary artery disease and preserved ejection fraction.
Autor: | Calvilho Júnior, Antonio Amador, Le Bihan, David, Barretto, Rodrigo Bellio de Mattos, Paladino Filho, Antonio Tito, Vilela, Andrea de Andrade, Pedra, Simone Rolim Fernandes Fontes, de Jesus, Carlos Alberto, Assef, Jorge Eduardo, Abizaid, Alexandre Antônio Cunha, Braga, Sérgio Luiz Navarro |
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Předmět: |
CORONARY heart disease surgery
HEART ventricle diseases BLOOD pressure CARDIAC catheterization CORONARY disease ECHOCARDIOGRAPHY LEFT heart ventricle LONGITUDINAL method STATISTICS DATA analysis CONTRAST media RECEIVER operating characteristic curves CORONARY angiography VENTRICULAR ejection fraction |
Zdroj: | Echocardiography; Jul2019, Vol. 36 Issue 7, p1263-1272, 10p |
Abstrakt: | Background: A weak correlation has been reported between left ventricular filling pressures and the traditional echocardiographic tools for the evaluation of diastolic function in patients with coronary artery disease (CAD) and preserved left ventricular ejection fraction (LVEF). On the other hand, studies that compared invasive measurements with speckle tracking echocardiography have shown promising results, but they were not exclusively targeted on this specific population. Methods and Results: Immediately before the left heart catheterization, a comprehensive two‐dimensional Doppler echocardiography and speckle tracking analysis was prospectively performed in outpatients referred for coronary angiography. Left ventricular end‐diastolic pressure (LVEDP) was measured before any contrast exposure. Eighty‐one patients with coronary artery disease were studied, and the group with high LVEDP (n = 40) showed increased left atrial volume index (22 ± 6 mL/m2 vs 26 ± 8.26 mL/m2, P = 0.04), E‐wave velocity (65 ± 15 cm/s vs 78 ± 20 cm/s, P = 0.02), E/e' (average) ratio (8.14 ± 2.0 vs 11.54 ± 2.7, P = 0.03), and E/global circumferential strain rate E peak ratio (E/GCSRE) (39 cm vs 46 cm, P < 0.01). There was a positive correlation between LVEDP and E/e' (ρ = 0.56; P = 0.03), and between LVEDP and E/GCSRE ratio (ρ = 0.43; P < 0.01). The area under the receiver operating characteristics (ROC) curve was 0.83 and 0.73, respectively (P < 0.05). E/e' and E/GCSRE were both independent predictors of elevated LVEDP (P < 0.05), with a higher C‐statistic for the model including E/e' (0.89 vs 0.85). Conclusion: The E/e' ratio was able to identify elevated LVEDP in CAD patients with preserved LVEF with more accuracy than the E/GCSRE ratio. [ABSTRACT FROM AUTHOR] |
Databáze: | Complementary Index |
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