Document Detail

Investigating the European Society of Cardiology Diastology Guidelines in a practical scenario.
MedLine Citation:
PMID:  18490295     Owner:  NLM     Status:  MEDLINE    
AIMS: Recently, the European Society of Cardiology (ESC) released a consensus statement for the diagnosis of heart failure with preserved ejection fraction (HFPEF). It state that E/e' > 15 or <8 clearly define those with or without HFPEF and that for those in the range 8-15, other parameters should be examined. METHODS AND RESULTS: We retrospectively analysed 1229 consecutive echocardiograms (57% males) for the utility of echocardiographic measures including left atrial volume index (LAVI), left ventricular mass index (LVMI), and pulmonary venous and mitral inflow Doppler. LAVI of 40 ml/m(2) provided the greatest sensitivity and specificity of 76 and 77%, respectively, with reference to E/e' for the detection of diastolic dysfunction. The ESC definition of raised LVMI yielded a sensitivity and specificity of 32 and 99%, respectively. We found that the mitral and pulmonary inflow provided little incremental information. These results remained consistent between those with normal and abnormal ejection fraction. CONCLUSIONS: There appears to be little incremental value of pulmonary and mitral Doppler measures beyond the measure of mitral E wave. An LAVI cut-off of 40 ml/m(2) maximizes both sensitivity and specificity. However, ESC guidelines of raised LVMI in patients with HFPEF would appear to heavily trade sensitivity for specificity.
William T Emery; Irfan Jadavji; Jonathan B Choy; Richard A Lawrance
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-04-23
Journal Detail:
Title:  European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology     Volume:  9     ISSN:  1532-2114     ISO Abbreviation:  Eur J Echocardiogr     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-21     Completed Date:  2008-12-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100890618     Medline TA:  Eur J Echocardiogr     Country:  England    
Other Details:
Languages:  eng     Pagination:  685-91     Citation Subset:  IM    
Division of Cadiology, University of Alberta Hospital, Edmonton, Alta, Canada.
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MeSH Terms
Cardiology / standards*
Echocardiography, Doppler / standards*
Middle Aged
Practice Guidelines as Topic / standards*
Retrospective Studies
Sensitivity and Specificity
Societies, Medical
Stroke Volume

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