Transthoracic Echocardiographic Parameters in the Estimation of Pulmonary Capillary Wedge Pressure in Patients With Present or Previous Heart Failure
| Autor: | Anita Phan, Robert J. Siegel, Faramarz Tehrani, Asim M. Rafique, Simon Biner |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Cardiac Catheterization medicine.medical_specialty Hemodynamics Risk Assessment Severity of Illness Index Cohort Studies Predictive Value of Tests Internal medicine Humans Medicine In patient Pulmonary Wedge Pressure Cardiac Output Pulmonary wedge pressure Aged Retrospective Studies Heart Failure Observer Variation Ejection fraction business.industry Stroke Volume Middle Aged Prognosis medicine.disease Survival Analysis Predictive value Deceleration time Logistic Models ROC Curve Echocardiography Heart failure Multivariate Analysis Heart catheterization Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | The American Journal of Cardiology. 110:689-694 |
| ISSN: | 0002-9149 |
| Popis: | Multiple echocardiographic criteria are routinely used for the estimation of left heart filling pressures. We assessed the predictive value of various echocardiographic parameters to estimate the left heart filling pressure and proposed a simplified approach for its evaluation. We collected the clinical, echocardiographic, and invasive hemodynamic data from 93 patients with heart failure who underwent right-sided heart catheterization and transthoracic echocardiography within a 24-hour period. Of these 93 patients, 57% had a left ventricular ejection fraction50% and 69% had an elevated mean pulmonary capillary wedge pressure of ≥ 15 mm Hg. A mitral E/E' of ≥ 15 had a sensitivity of 55% but a specificity of 96%. A left atrial area of ≥ 20 cm(2) had a sensitivity of 66% and specificity of 89%. A deceleration time140 ms had a sensitivity of 51% and specificity of 93% to predict a pulmonary capillary wedge pressure of ≥ 15 mm Hg. The combination of E/E' ≥ 15 ± left atrial area of ≥ 20 cm(2) ± deceleration time140 ms provided a sensitivity of 92% and specificity of 85%. On multivariate analysis, the combination of E/E' ≥ 15, left atrial area of ≥ 20 cm(2), and deceleration time140 ms was the most significant predictor of a pulmonary capillary wedge pressure of ≥ 15 mm Hg (odds ratio 48, 95% confidence interval 10 to 289, p0.001). In conclusion, this simplified approach using 3 echocardiographic parameters provides an accurate and a practical approach for the routine estimation of the elevated left heart filling pressure. |
| Databáze: | OpenAIRE |
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