Introduction
Material and methods
Right heart catheterization
Echocardiographic examination
Assessment of LA and LV deformation function
Statistics
Results
Reproducibility of LA and LV speckle tracking measurements
Patients clinical, hemodynamic and echocardiography characteristics (Tables 1 and 2)
Diagnosis | Number |
---|---|
ASD/VSD | 5 |
Rheumatic disease (SSc,SLE,RA,MCD) | 30 (24,2,1,3) |
CTPH | 12 |
Pulmonary disease | 13 |
Heart failure with LVEF > = 50% (%) | 63 |
Heart failure reduced LVEF, < 50% (%) | 37 |
Other (sarcoidosis, constrictive pericarditis, cardiac amyloidosis) | 4 |
Systemic hypertension | 55 |
Diabetes mellitus | 17 |
Ischemic disease | 22 |
Medications | |
Betablockers | 56 |
ACE/ARB | 78 |
Diuretics | 84 |
PAH medication | 46 |
N | Mean | SD | |
---|---|---|---|
Height, cm | 144 | 169 | 10 |
Weight, kg | 144 | 78 | 17 |
BSA, m2 | 144 | 2.0 | 0.2 |
SBP, mmHg | 144 | 132 | 20 |
DBP,mmHg | 144 | 78 | 11 |
NT-proBNP, ug/L | 121 | 1893 | 3155 |
Log NT-proBNP,ug/L | 121 | 2.8 | 0.6 |
Right heart catheterization | |||
TPG,mmHg | 142 | 20 | 14 |
PVR,WU | 143 | 4.2 | 3.3 |
RAP,mmHg | 143 | 8.3 | 5.6 |
PCWP,mmHg | 144 | 12.8 | 6.2 |
RVEDP,mmHg | 115 | 10.5 | 5.1 |
MPAP,mmHg | 144 | 33 | 14 |
Echocardiography | |||
IVS,mm | 129 | 10.7 | 2.7 |
LVDD,mm | 130 | 49 | 10 |
PWT,mm | 125 | 8.1 | 2.1 |
HR,bpm | 144 | 74 | 14 |
IVRT,ms | 118 | 86 | 28 |
DT,ms | 131 | 152 | 58 |
Lat s’,cm/s | 125 | 6.5 | 2.1 |
Lat e’,cm/s | 125 | 8.2 | 3.4 |
LVEF,% | 135 | 53 | 13 |
E/e’ lateral | 111 | 10.7 | 5.9 |
PVF S/D | 67 | 1.0 | 0.5 |
LAVI,ml/m2 | 134 | 33 | 19 |
TR gradient, m/s | 125 | 47 | 19 |
LA strain/strain rate | |||
LASRs, 1/s | 138 | 0.84 | 0.45 |
LASRe, 1/s | 134 | 0.82 | 0.57 |
LASRa, 1/s | 108 | 1.21 | 0.64 |
LASs, % | 138 | 15.1 | 9.0 |
LV strain/strain rate | |||
LVSRs, 1/s | 132 | 0.81 | 0.29 |
LVSRe, 1/s | 133 | 1.01 | 0.53 |
LVSRa, 1/s | 108 | 0.83 | 0.43 |
LV GLS, % | 136 | 14.5 | 6.1 |
Conventional echocardiographic measures and their relationship with LV filling pressures
All patients | Patients with LAVI > 34 ml/m2 | |||||
---|---|---|---|---|---|---|
n | r2 | p-value | N | r2 | p-value | |
LA strain | ||||||
LASRs,1/s | 137 | 0.21 | < 0.001 | 48 | 0.14 | 0.010 |
LASRe,1/s | 133 | 0.03 | 0.061 | 47 | 0.00 | 0.814 |
LASRa,1/s | 108 | 0.40 | < 0.001 | 32 | 0.60 | < 0.001 |
LASs,% | 138 | 0.19 | < 0.001 | 48 | 0.17 | 0.004 |
LV strain | ||||||
LVSRs,1/s | 131 | 0.14 | < 0.001 | 45 | 0.10 | 0.041 |
LVSRe,1/s | 132 | 0.27 | 0.1 | 45 | 0.01 | 0.215 |
LVSRa,1/s | 132 | 0.27 | < 0.001 | 32 | 0.32 | 0.001 |
LV GLS,% | 136 | 0.13 | < 0.001 | 47 | 0.16 | 0.006 |
Conventional Doppler | ||||||
Mitral DT | 131 | 0.25 | < 0.001 | 43 | 0.17 | 0.03 |
IVRT | 118 | 0.16 | < 0.001 | 38 | 0.18 | 0.07 |
E/A | 108 | 0.41 | < 0.001 | 30 | 0.50 | < 0.001 |
E/e’ lat | 95 | 0.18 | < 0.001 | 33 | 0.07 | 0.133 |
PVF, S/D | 67 | 0.32 | < 0.001 | 20 | 0.34 | 0.05 |
LA & LV deformation and PCWP
Correlation between LA and LV deformation (supplemental file, Table 5)
Recommended multi- and univariate models for predicting elevated PCWP
Model | Sensitivity | Specificity | PPV | NPV | Accuracy |
---|---|---|---|---|---|
Modified algorithm, combined model [7] | 42 | 80 | 42 | 80 | 70 |
E/e’ lateral > 12 | 47 | 86 | 61 | 78 | 74 |
TR velocity > 2.8 m/s | 80 | 28 | 40 | 70 | 48 |
LASRa, < 0.9 1/s | 70 | 97 | 92 | 86 | 88 |