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Evaluation of left ventricular filling pressure by echocardiography in patients with atrial fibrillation.
Khan, Faraz H; Zhao, Debbie; Ha, Jong-Won; Nagueh, Sherif F; Voigt, Jens-Uwe; Klein, Allan L; Gude, Einar; Broch, Kaspar; Chan, Nicholas; Quill, Gina M; Doughty, Robert N; Young, Alistair; Seo, Ji-Won; García-Izquierdo, Eusebio; Moñivas-Palomero, Vanessa; Mingo-Santos, Susana; Wang, Tom Kai Ming; Bezy, Stephanie; Ohte, Nobuyuki; Skulstad, Helge; Beladan, Carmen C; Popescu, Bogdan A; Kikuchi, Shohei; Panis, Vasileios; Donal, Erwan; Remme, Espen W; Nash, Martyn P; Smiseth, Otto A.
Afiliación
  • Khan FH; Institute for Surgical Research, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, University of Oslo, Rikshospitalet, Oslo, N-0027, Norway.
  • Zhao D; Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand.
  • Ha JW; Cardiology Division, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • Nagueh SF; Methodist DeBakey Heart and Vascular Center, Houston, TX, USA.
  • Voigt JU; Department of Cardiovascular Diseases, Department of Cardiovascular Sciences, University Hospitals Leuven, Catholic University of Leuven, Leuven, Belgium.
  • Klein AL; Cleveland Clinic, Cleveland, OH, USA.
  • Gude E; Institute for Surgical Research, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, University of Oslo, Rikshospitalet, Oslo, N-0027, Norway.
  • Broch K; Institute for Surgical Research, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, University of Oslo, Rikshospitalet, Oslo, N-0027, Norway.
  • Chan N; Cleveland Clinic, Cleveland, OH, USA.
  • Quill GM; Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand.
  • Doughty RN; Department of Medicine, University of Auckland, Auckland, New Zealand.
  • Young A; Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand.
  • Seo JW; Cardiology Division, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • García-Izquierdo E; Cardiology Unit, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
  • Moñivas-Palomero V; Cardiology Unit, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
  • Mingo-Santos S; Cardiology Unit, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
  • Wang TKM; Cleveland Clinic, Cleveland, OH, USA.
  • Bezy S; Department of Cardiovascular Diseases, Department of Cardiovascular Sciences, University Hospitals Leuven, Catholic University of Leuven, Leuven, Belgium.
  • Ohte N; Department of cardiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
  • Skulstad H; Institute for Surgical Research, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, University of Oslo, Rikshospitalet, Oslo, N-0027, Norway.
  • Beladan CC; University of Medicine and Pharmacy "Carol Davila", Emergency Institute for, Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Sos. Fundeni 258, sector 2, Euroecolab, Bucharest, 0223228, Romania.
  • Popescu BA; University of Medicine and Pharmacy "Carol Davila", Emergency Institute for, Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Sos. Fundeni 258, sector 2, Euroecolab, Bucharest, 0223228, Romania.
  • Kikuchi S; Department of cardiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
  • Panis V; Department of Cardiology, CHU Rennes and Inserm, LTSI, University of Rennes, Rennes, France.
  • Donal E; Department of Cardiology, CHU Rennes and Inserm, LTSI, University of Rennes, Rennes, France.
  • Remme EW; Institute for Surgical Research, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, University of Oslo, Rikshospitalet, Oslo, N-0027, Norway.
  • Nash MP; The Intervention Centre, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
  • Smiseth OA; Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand.
Echo Res Pract ; 11(1): 14, 2024 Jun 03.
Article en En | MEDLINE | ID: mdl-38825684
ABSTRACT

BACKGROUND:

Echocardiography is widely used to evaluate left ventricular (LV) diastolic function in patients suspected of heart failure. For patients in sinus rhythm, a combination of several echocardiographic parameters can differentiate between normal and elevated LV filling pressure with good accuracy. However, there is no established echocardiographic approach for the evaluation of LV filling pressure in patients with atrial fibrillation. The objective of the present study was to determine if a combination of several echocardiographic and clinical parameters may be used to evaluate LV filling pressure in patients with atrial fibrillation.

RESULTS:

In a multicentre study of 148 atrial fibrillation patients, several echocardiographic parameters were tested against invasively measured LV filling pressure as the reference method. No single parameter had sufficiently strong association with LV filling pressure to be recommended for clinical use. Based on univariate regression analysis in the present study, and evidence from existing literature, we developed a two-step algorithm for differentiation between normal and elevated LV filling pressure, defining values ≥ 15 mmHg as elevated. The parameters in the first step included the ratio between mitral early flow velocity and septal mitral annular velocity (septal E/e'), mitral E velocity, deceleration time of E, and peak tricuspid regurgitation velocity. Patients who could not be classified in the first step were tested in a second step by applying supplementary parameters, which included left atrial reservoir strain, pulmonary venous systolic/diastolic velocity ratio, and body mass index. This two-step algorithm classified patients as having either normal or elevated LV filling pressure with 75% accuracy and with 85% feasibility. Accuracy in EF ≥ 50% and EF < 50% was similar (75% and 76%).

CONCLUSIONS:

In patients with atrial fibrillation, no single echocardiographic parameter was sufficiently reliable to be used clinically to identify elevated LV filling pressure. An algorithm that combined several echocardiographic parameters and body mass index, however, was able to classify patients as having normal or elevated LV filling pressure with moderate accuracy and high feasibility.
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Texto completo: 1 Base de datos: MEDLINE Idioma: En Revista: Echo Res Pract Año: 2024 Tipo del documento: Article País de afiliación: Noruega

Texto completo: 1 Base de datos: MEDLINE Idioma: En Revista: Echo Res Pract Año: 2024 Tipo del documento: Article País de afiliación: Noruega