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Eur Heart J Cardiovasc Imaging. 2017 Sep 1;18(9):961-968. doi: 10.1093/ehjci/jex067.

Echo-Doppler estimation of left ventricular filling pressure: results of the multicentre EACVI Euro-Filling study.

Author information

1
GIGA Cardiovascular Science, Heart Valve Clinic, Imaging Cardiology, University of Liège Hospital, B-4000 Liege, Belgium.
2
Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy.
3
Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy.
4
Department of Cardiology, Oslo University Hospital, Rikshospitalet and University of Oslo, Centre of Cardiological Innovation, Oslo, Norway.
5
Cardiologie, CHU Rennes and LTSI-INSERM U 1099, Université Rennes 1, France.
6
Division of Cardiology, Second Department of Medicine, Medical University of Vienna, Vienna, Austria.
7
Multimodality Cardiac Imaging Department, Sports Cardiology and Cardiomyopathies centre Hospital da Luz, Lisbon, Portugal.
8
CHU Limoges, Hôpital Dupuytren, Pôle Coeur-Poumon-Rein, Cardiology Department, Limoges, France.
9
Echokardiographie-Labore des Universitätsklinikums AöR, Department of Cardiology-Angiology, University of Leipzig, Leipzig, Germany.
10
University of Medicine and Pharmacy "Carol Davila"-Euroecolab, Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Bucharest, Romania.
11
Heart Center, Sheba Medical Center, Tel Hashomer, and Tel Aviv University, Ramat Aviv, Israel.
12
URMITE, Aix Marseille Université UM63, CNRS 7278, IRD 198, INSERM 1095 IHU - Méditerranée Infection.
13
APHM, La Timone Hospital, Cardiology Department, Marseille, France.

Abstract

Aims:

The present Euro-Filling report aimed at comparing the diagnostic accuracy of the 2009 and 2016 echocardiographic grading algorithms for predicting invasively measured left ventricular filling pressure (LVFP).

Method and results:

A total of 159 patients who underwent simultaneous evaluation of echo estimates of LVFP and invasive measurements of LV end-diastolic pressure (LVEDP) were enrolled at nine EACVI centres. Thirty-nine (25%) patients had a reduced LV ejection fraction (<50%), 77 (64%) were in NYHA ≥ II, and 85 (53%) had coronary artery disease. Sixty-four (40%) patients had elevated LVEDP (≥15 mmHg). Taken individually, all echocardiographic Doppler estimates of LVFP (E/A, E/e', left atrial volume, tricuspid regurgitation jet velocity) were marginally correlated with LVEDP. By using the 2016 recommendations, 65% of patients with normal non-invasive estimate of LVFP had normal LVEDP, while 79% of those with elevated non-invasive LVFP had elevated invasive LVEDP. By using 2009 recommendations, 68% of the patients with normal non-invasive LVFP had normal LVEDP, while 55% of those with elevated non-invasive LVFP had elevated LVEDP. The 2016 recommendations (sensitivity 75%, specificity 74%, positive predictive value 39%, negative predictive value 93%, AUC 0.78) identified slightly better patients with elevated invasive LVEDP (≥ 15 mmHg) as compared with the 2009 recommendations (sensitivity 43%, specificity 75%, positive predictive value 49%, negative predictive value 71%, AUC 0.68).

Conclusion:

The present Euro-Filling study demonstrates that the new 2016 recommendations for assessing LVFP non-invasively are fairly reliable and clinically useful, as well as superior to the 2009 recommendations in estimating invasive LVEDP.

KEYWORDS:

cardiac catheterization; echo Doppler; left ventricular end-diastolic pressure; left ventricular filling pressure; pulsed tissue Doppler

PMID:
28444160
DOI:
10.1093/ehjci/jex067
[Indexed for MEDLINE]

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