Document Detail


Echocardiographic evaluation of hemodynamics in patients with decompensated systolic heart failure.
MedLine Citation:
PMID:  21398512     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Doppler echocardiography is currently applied for the assessment of left ventricular and right ventricular hemodynamics in patients with cardiovascular disease. However, there are conflicting reports about its accuracy in patients with unstable decompensated heart failure. The objective of this study was to evaluate the accuracy of the technique in patients with unstable heart failure.
METHODS AND RESULTS: Consecutive patients with decompensated heart failure had simultaneous assessment of left ventricular and right ventricular hemodynamics invasively and by Doppler echocardiography. In 79 patients, the noninvasive measurements of stroke volume (r=0.83, P<0.001), pulmonary artery systolic (r=0.83, P<0.001) and diastolic pressure (r=0.51, P=0.009), and mean right atrial pressure (r=0.85, P<0.001) all had significant correlations with invasively acquired measurements. Several Doppler indices had good accuracy in identifying patients with pulmonary capillary wedge pressure >15 mm Hg (area under the curve, 0.86 to 0.92). The recent American Society of Echocardiography/European Association of Echocardiography guidelines were highly accurate (sensitivity, 98%; specificity, 91%) in identifying patients with increased wedge pressure. In 12 repeat studies, Doppler echocardiography readily detected the changes in mean wedge pressure (r=0.75, P=0.005) as well as changes in pulmonary artery systolic pressure and mean right atrial pressure.
CONCLUSIONS: Doppler echocardiography provides reliable assessment of right and left ventricular hemodynamics in patients with decompensated heart failure.
Authors:
Sherif F Nagueh; Rajat Bhatt; Rey P Vivo; Selim R Krim; Sebastian Imre Sarvari; Kristoffer Russell; Thor Edvardsen; Otto A Smiseth; Jerry D Estep
Publication Detail:
Type:  Journal Article     Date:  2011-03-11
Journal Detail:
Title:  Circulation. Cardiovascular imaging     Volume:  4     ISSN:  1942-0080     ISO Abbreviation:  Circ Cardiovasc Imaging     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-18     Completed Date:  2011-08-17     Revised Date:  2011-09-06    
Medline Journal Info:
Nlm Unique ID:  101479935     Medline TA:  Circ Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  220-7     Citation Subset:  IM    
Affiliation:
Methodist DeBakey Heart and Vascular Center, Houston, TX 77030, USA. snagueh@tmhs.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Blood Flow Velocity
Blood Pressure
Cardiac Output
Cardiac Volume
Echocardiography, Doppler*
Female
Heart Catheterization
Heart Failure, Systolic / physiopathology*,  ultrasonography
Hemodynamics*
Humans
Male
Middle Aged
Pulmonary Wedge Pressure
Sensitivity and Specificity
Stroke Volume
Ventricular Function*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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