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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...

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Autores principales: Ran, Hong, Schneider, Matthias, Pistritto, Anna Maria, Gerges, Christian, Heidari, Houtan, Binder, Thomas, Lang, Irene, Goliasch, Georg
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Netherlands 2019
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.
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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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