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Tissue Doppler Imaging-Derived Myocardial Acceleration During Isovolumetric Contraction Predicts Pulmonary Capillary Wedge Pressure in Patients With Reduced Ejection Fraction.
MedLine Citation:
PMID:  22473456     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: Tissue Doppler imaging-obtained isovolumetric myocardial acceleration (IVA) is load independent, reportedly predicts systolic functions, and correlates with exercise capacity in patients with reduced ejection fraction (EF). We hypothesized that IVA correlates with the pulmonary capillary wedge pressure (PCWP) in patients with reduced EF. Methods and Results: Of 113 patients, correlations between PCWP and IVA were done for all patients, 48 patients with EF ≥55%, and 65 patients with EF <55%. Results were compared to the correlation between PCWP and other echocardiographic predictors. IVA correlated moderately with PCWP in all patients (r=0.54, P<0.0001) and was comparable to the E/A and E/e' ratios. In patients with EF ≥55%, IVA lost correlation and the only predictor was the E/e' ratio (r=0.08, 0.58, P=0.58, <0.0001). In patients with EF <55%, IVA was better than E/A and E/e' (r=0.72, 0.61, 0.51, P<0.0001), especially for atrial fibrillation or when E/e' fell between 8 and 15. Furthermore, IVA >1.60m/s(2) can predict PCWP ≥15mmHg, with a sensitivity of 95%, specificity of 73%, and an area under the curve of 0.867 (P<0.0001). Conclusions: IVA can predict PCWP in patients with reduced EF, and can be considered an alternative to the E/e' ratio for patients with atrial fibrillation or E/e' ratio between 8 and 15.
Authors:
Alaa Mabrouk Salem Omar; Hidekazu Tanaka; Kensuke Matsumoto; Kazuhiro Tatsumi; Tatsuya Miyoshi; Mana Hiraishi; Takayuki Tsuji; Akihiro Kaneko; Keiko Ryo; Yuko Fukuda; Hiroya Kawai; Ken-Ichi Hirata
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-3
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  -     ISSN:  1347-4820     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine.
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