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Orso D, Sabbadin M, Bacchetti G, Simeoni G, Bove T. Correlation Between Tissue Doppler Imaging Method (E/e') and Invasive Measurements of Left Ventricular Filling Pressures: A Systematic Review, Meta-Analysis, and Meta-Regression. J Cardiothorac Vasc Anesth 2024:S1053-0770(24)00534-2. [PMID: 39218765 DOI: 10.1053/j.jvca.2024.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 07/21/2024] [Accepted: 08/07/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVES Evaluation of pulmonary capillary wedge pressure (PCWP) through right heart catheterization can indirectly provide an estimation of the filling pressure of the left ventricle. Echocardiography can estimate left ventricular compliance using mitral annular tissue Doppler imaging (TDI). The E/e' ratio refers to the correlation between the peak mitral inflow (E-wave) velocity and early diastolic tissue Doppler mitral annular velocity (e'). The main purpose of this systematic review was to establish the correlation between echocardiographic E/e' ratio and PCWP. The correlation between E/e' and left ventricular end-diastolic pressure (LVEDP) was evaluated as a secondary objective. DESIGN A systematic review and meta-analysis of observational studies was conducted. The search was based on Medline (PubMed), Scopus, and Web of Science. SETTING Intensive care unit or cardiac intensive care unit. PARTICIPANTS Adult patients. INTERVENTIONS Any study comparing the left ventricular filling pressure obtained by cardiac catheterization (reference) and echocardiographic evaluation, in particular TDI analysis (intervention), were included. MEASUREMENTS AND MAIN RESULTS The pooled analysis included 94 studies from the initially identified 7,304 records. The correlation was 0.48 (95% CI 0.42-0.54, Q = 420.52, I2 = 84.8%) for PCWP and 0.50 (95% CI 0.38-0.60, Q = 210.91, I2 = 89.1%) for LVEDP. CONCLUSIONS The E/e' ratio moderately correlated with PCWP/LVEDP. The correlation was stable irrespective of the sites where e' was measured, but each site has its own limitations for specific patient subpopulations. The correlation was weak in patients with heart failure with a preserved ejection fraction.
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Affiliation(s)
- Daniele Orso
- Department of Anesthesia and Intensive Care, ASUFC University Hospital of Udine, Udine, Italy.
| | - Marta Sabbadin
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | | | - Gabriele Simeoni
- Department of Anesthesia and Intensive Care, ASUFC University Hospital of Udine, Udine, Italy
| | - Tiziana Bove
- Department of Anesthesia and Intensive Care, ASUFC University Hospital of Udine, Udine, Italy; Department of Medicine (DAME), University of Udine, Udine, Italy
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Durmaz E, Karpuz MH, İkitimur B, Karadag B, Koca D, Ohtaroglu Tokdil K, Raimoglu U, Gulfidan A, Incesu G, Tokdil H, Pirdal BZ, Ongen Z. The validation of left atrial strain imaging for the assessment of diastolic functions in patients with ST-segment elevation myocardial infarction. Int J Cardiovasc Imaging 2022; 38:2109-2114. [PMID: 37726461 PMCID: PMC9116073 DOI: 10.1007/s10554-022-02628-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 04/18/2022] [Indexed: 01/28/2023]
Abstract
Assessment of left ventricular filling pressure (LVFP) is crucial in patients with ST-segment elevation myocardial infarction (STEMI). Since current guideline recommended echocardiographic parameters have limited value, more comprehensive assessment methods are required in this patient subset.In this study, we aimed to investigate the clinical utility of left atrial reservoir strain (LARS) imaging in patients treated with primary percutaneous coronary intervention (pPCI). Patients who underwent successful pPCI were included. Left ventricular end-diastolic pressure (LVEDP) was measured invasively following pPCI. Left atrial strain imaging was performed following pPCI within 24 h of pPCI. Normal LARS value was accepted as above 23%. We prospectively enrolled 69 patients; there were 18 patients with LARS below 23% who were included into group 1 and rest of the study population included into group 2. There was no significant difference between groups in terms of comorbidities.Troponin and pro-BNP levels were significantly higher in group 1 (p: 0.036 and 0.047 respectively). Left atrial volume and tricuspid regurgitation velocity were similar between groups (p: 0.416 and p: 0.351 respectively). Septal tissue velocity was higher (p: 0.001) and Septal E/e' ratio was lower (p: 0.004) in group 2. Left ventricular (LV) global longitudinal strain value was higher in group 1 which is consistent with observed lower ejection (LVEF) fraction in group 1 (p: 0.001 for LV strain and p: 0.001 for LVEF). Estimated mean LVFP was also higher in group 1 (p: 0.003).Correlation analyses revealed moderate correlation between LARS and LVEDP (r: - 0.300). Our results indicate that left atrial strain imaging is a promising tool for the assessment of left atrial pressure in patients with STEMI.
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Affiliation(s)
- Eser Durmaz
- Department of Cardiology, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa Street, Fatih, Istanbul, 34098, Turkey.
| | - Mehmet Hakan Karpuz
- Department of Cardiology, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa Street, Fatih, Istanbul, 34098, Turkey
| | - Baris İkitimur
- Department of Cardiology, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa Street, Fatih, Istanbul, 34098, Turkey
| | - Bilgehan Karadag
- Department of Cardiology, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa Street, Fatih, Istanbul, 34098, Turkey
| | - Damla Koca
- Department of Cardiology, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa Street, Fatih, Istanbul, 34098, Turkey
| | - Kardelen Ohtaroglu Tokdil
- Department of Cardiology, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa Street, Fatih, Istanbul, 34098, Turkey
| | - Utku Raimoglu
- Department of Cardiology, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa Street, Fatih, Istanbul, 34098, Turkey
| | - Aslı Gulfidan
- Department of Cardiology, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa Street, Fatih, Istanbul, 34098, Turkey
| | - Gunduz Incesu
- Department of Cardiology, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa Street, Fatih, Istanbul, 34098, Turkey
| | - Hasan Tokdil
- Department of Cardiology, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa Street, Fatih, Istanbul, 34098, Turkey
| | - Betul Zehra Pirdal
- Department of Public Health, Cerrahpasa School of Medicine, I Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Zeki Ongen
- Department of Cardiology, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa Street, Fatih, Istanbul, 34098, Turkey
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