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Echocardiographic evaluation of left ventricular filling pressures in patients with pulmonary hypertension
Echocardiographic assessment of diastolic dysfunction depends on surrogate parameters. In recent years, guideline committees attempted to combine these parameters to diagnostic flowcharts allowing for correct classification of left ventricular filling pressures (LVFP). The value of these diagnostic...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Netherlands
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6486531/ https://www.ncbi.nlm.nih.gov/pubmed/30666551 http://dx.doi.org/10.1007/s10554-019-01528-6 |
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author | Ran, Hong Schneider, Matthias Pistritto, Anna Maria Gerges, Christian Heidari, Houtan Binder, Thomas Lang, Irene Goliasch, Georg |
author_facet | Ran, Hong Schneider, Matthias Pistritto, Anna Maria Gerges, Christian Heidari, Houtan Binder, Thomas Lang, Irene Goliasch, Georg |
author_sort | Ran, Hong |
collection | PubMed |
description | Echocardiographic assessment of diastolic dysfunction depends on surrogate parameters. In recent years, guideline committees attempted to combine these parameters to diagnostic flowcharts allowing for correct classification of left ventricular filling pressures (LVFP). The value of these diagnostic tools is limited if the applied surrogate parameters are elevated due to other reasons as is the case with maximal tricuspid regurgitation velocity. We aimed to compare the accuracy of the 2009 and the 2016 guideline recommendations in patients with pulmonary hypertension (PH). We included 101 consecutive patients who underwent right heart catheterization and transthoracic echocardiography for suspicion of PH. For the final analysis, only patients with PH were considered. The 2009 and 2016 recommendations for the assessment of diastolic function by echocardiography were applied on each patient. A total of 63 PH patients were included in the final analysis, 43% had elevated LVFP. By using the 2009 recommendations, sensitivity for correct classification of diastolic dysfunction was 67%, specificity was 82%, area under the curve (AUC) was 0.74. By using the 2016 recommendations, sensitivity for correct classification of diastolic dysfunction was 84%, specificity was 80%, AUC was 0.82. In ROC comparison, the AUC for the 2016 recommendations with 0.82 was significantly better compared to the AUC of 0.74 for the 2009 recommendations (p = 0.04). Our study demonstrates that the 2016 recommendations for echocardiographic evaluation of diastolic function are superior to the 2009 recommendations in estimating left ventricular filling pressures in patients with PH. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s10554-019-01528-6) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6486531 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Springer Netherlands |
record_format | MEDLINE/PubMed |
spelling | pubmed-64865312019-05-15 Echocardiographic evaluation of left ventricular filling pressures in patients with pulmonary hypertension Ran, Hong Schneider, Matthias Pistritto, Anna Maria Gerges, Christian Heidari, Houtan Binder, Thomas Lang, Irene Goliasch, Georg Int J Cardiovasc Imaging Original Paper Echocardiographic assessment of diastolic dysfunction depends on surrogate parameters. In recent years, guideline committees attempted to combine these parameters to diagnostic flowcharts allowing for correct classification of left ventricular filling pressures (LVFP). The value of these diagnostic tools is limited if the applied surrogate parameters are elevated due to other reasons as is the case with maximal tricuspid regurgitation velocity. We aimed to compare the accuracy of the 2009 and the 2016 guideline recommendations in patients with pulmonary hypertension (PH). We included 101 consecutive patients who underwent right heart catheterization and transthoracic echocardiography for suspicion of PH. For the final analysis, only patients with PH were considered. The 2009 and 2016 recommendations for the assessment of diastolic function by echocardiography were applied on each patient. A total of 63 PH patients were included in the final analysis, 43% had elevated LVFP. By using the 2009 recommendations, sensitivity for correct classification of diastolic dysfunction was 67%, specificity was 82%, area under the curve (AUC) was 0.74. By using the 2016 recommendations, sensitivity for correct classification of diastolic dysfunction was 84%, specificity was 80%, AUC was 0.82. In ROC comparison, the AUC for the 2016 recommendations with 0.82 was significantly better compared to the AUC of 0.74 for the 2009 recommendations (p = 0.04). Our study demonstrates that the 2016 recommendations for echocardiographic evaluation of diastolic function are superior to the 2009 recommendations in estimating left ventricular filling pressures in patients with PH. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s10554-019-01528-6) contains supplementary material, which is available to authorized users. Springer Netherlands 2019-01-21 2019 /pmc/articles/PMC6486531/ /pubmed/30666551 http://dx.doi.org/10.1007/s10554-019-01528-6 Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Original Paper Ran, Hong Schneider, Matthias Pistritto, Anna Maria Gerges, Christian Heidari, Houtan Binder, Thomas Lang, Irene Goliasch, Georg Echocardiographic evaluation of left ventricular filling pressures in patients with pulmonary hypertension |
title | Echocardiographic evaluation of left ventricular filling pressures in patients with pulmonary hypertension |
title_full | Echocardiographic evaluation of left ventricular filling pressures in patients with pulmonary hypertension |
title_fullStr | Echocardiographic evaluation of left ventricular filling pressures in patients with pulmonary hypertension |
title_full_unstemmed | Echocardiographic evaluation of left ventricular filling pressures in patients with pulmonary hypertension |
title_short | Echocardiographic evaluation of left ventricular filling pressures in patients with pulmonary hypertension |
title_sort | echocardiographic evaluation of left ventricular filling pressures in patients with pulmonary hypertension |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6486531/ https://www.ncbi.nlm.nih.gov/pubmed/30666551 http://dx.doi.org/10.1007/s10554-019-01528-6 |
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