Echocardiographic Evaluation of Left Ventricular Filling Pressure in Patients With Heart Failure With Preserved Ejection Fraction: Usefulness of Inferior Vena Cava Measurements and 2016 EACVI/ASE Recommendations
| Autor: | Philippe Hervé, Patrick Assayag, Denis Chemla, Amir Bouchachi, Thibaud Damy, Barnabas Gellen, Minh Tam Bailly, Alexandra Rouquette, Patrick Jourdain, E. Berthelot |
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| Rok vydání: | 2020 |
| Předmět: |
Cardiac Catheterization
medicine.medical_specialty Vena Cava Inferior 030204 cardiovascular system & hematology Inferior vena cava Ventricular Function Left 03 medical and health sciences 0302 clinical medicine Internal medicine Ventricular Pressure medicine Humans Sinus rhythm 030212 general & internal medicine Pulmonary wedge pressure Heart Failure Ejection fraction business.industry Central venous pressure Stroke Volume medicine.disease Pulmonary hypertension medicine.vein Echocardiography Heart failure cardiovascular system Cardiology Cardiology and Cardiovascular Medicine Heart failure with preserved ejection fraction business |
| Zdroj: | Journal of Cardiac Failure. 26:507-514 |
| ISSN: | 1071-9164 |
| DOI: | 10.1016/j.cardfail.2020.01.018 |
| Popis: | The left ventricular filling pressure (LVFP) is correlated to right atrial pressure (RAP) in heart failure. We compared diagnostic value of the inferior vena cava (IVC) measurements to the one of the 2016 echocardiographic recommendations to estimate LVFP in patients with suspected heart failure with preserved ejection fraction (HFpEF).Invasive hemodynamics and echocardiography were obtained within 48 hours in 132 consecutive patients with left ventricular ejection fraction ≥50%, and suspected pulmonary hypertension. Increased LVFP was defined by a pulmonary artery wedge pressure (PAWP)15 mmHg.Of 83 patients in sinus rhythm, a score of the 2016 recommendations ≥ 2 (E/e' ratio14 and/or tricuspid regurgitation velocity2.8 m/s and/or indexed left atrial volume34 mL /m²) had a positive predictive value (PPV) of 63% for PAWP15 mmHg, whereas a dilated IVC (2.1 cm) and/or non-collapsible (≤50%) had a PPV of 82%. The net reclassification improvement was 0.39 (P.05). In atrial fibrillation (AF), a dilated and/or non-collapsible IVC had an 86% PPV for PAWP15 mmHg. The correlation between RAP and PAWP was 0.60, with 75.7% concordance (100/132) between dichotomized pressures (both RAP8 mmHg and PAWP15 mmHg and vice versa).The IVC size and collapsibility is valuable to identify patients with HFpEF with high LVFP in both sinus rhythm and AF. |
| Databáze: | OpenAIRE |
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