0056: Assessment of left ventricular filling pressures: a prospective speckle tracking echocardiography compared to invasive hemodynamic study

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• 作者：Julien Voyez ; ^{julien.voyez@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Anthony Foulon ; Bertrand Girodet ; Mathias Guinot ; Karine Bauley ; Pierre Nazeyrollas ; Damien Metz
• 刊名：Archives of Cardiovascular Diseases Supplements
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：8
• 期：1
• 页码：45
• 全文大小：314 K

文摘

Assessment of left ventricular filling pressures (LVFP) is a key part of echocardiographic evaluation but actual validated parameters aren’t relevant in some routine cases. Use of diastolic strain rates (DSr) may improve the diagnostic of elevated LVFP in specific cardiomyopathies. Our primary objective was to evaluate the diagnostic performance for elevated LVFP of different DSr indexes in a heterogenous cardiological population.

Material and Methods

We led a prospective mono-centric two-dimensional speckle tracking echocardiography study compared to invasive hemo-dynamic (left catheterization with measurement of pre-atrial pressure (preA)). Elevation of LVFP was defined as preA>15mmHg. Global DSr indexes tested were: isovolumetric relaxation DSr (IvrDSr), early DSr (EarlyDSr) and late DSr (LateDSr). Additional DSr indexes were calculated by meaning of these parameters: EarlyLateDSr and IvrEarlyLateDSr. DSr values were multiplied by 10 factor and ratios of E wave to the obtained result gave different composite E/10DSr indexes.

Results

Fifty height patients were included. Patients with preA>15mmHg (n=23) were compared with patients with preA<15mmHg (n=35). Mean left ventricular ejection fraction (LVEF) was 55,7±13,3%, mean preA was 13,6±6,2mmHg.

52% of patients had coronaropathy, 43% had regional dysfunction and 31% had significant valvulopathy. Correlations to LVFP were: E/10IvrEarlyLateDSr (R=0,50), E/10LateDSr (R=0,46), E/10EarlyLateDSr (R=0,42).

Optimal cut off values were 11,5 for E/10LateDSr (sensitivity (Se) 64%, specificity (Spe) 91%, positive predictive value (PPV) 82% and negative predictive value (NPV) 80%), 9,5 for E/10EarlyLateDSr (Se 68%, Spe 83%, PPV 71%, NPV 81%) and 15 for E/10IvrEarlyLateDSr (Se 75%, Spe 85%, PPV 79%, NVP 82%).

Conclusion

E/10DSr composite indexes, especially E/10LateDSr and E/ 10IvrEarlyLateDSr are relevant LVFP indexes, which may be applied to a large spectrum of cardiomyopathies.