Correlation of Doppler echocardiography with cardiac catheterization in estimating pulmonary capillary wedge pressure: A tertiary level hospital finding in Bangladesh

Abstract

IntroductionPulmonary Capillary Wedge Pressure (PCWP) is an established index of cardiac function and an essential component in the management of patients with congestive heart failure and in critically ill patients. It provides the haemodynamic status in patients with acute myocardial infarction. Several Doppler echocardiographic assessments of haemodynamic variables in patients with advanced heart failure are accurate and reproducible. This noninvasive methodology may assist with monitoring and optimizing medical therapy in such patients. At present echocardiography is the most useful and widespread tool used in heart failure patients with regard to diagnosis, assessment and haemodynamic characterization 1-3 . Mitral Doppler echocardiography provides a simple and noninvasive method of estimating and monitoring PCWP in patients with severe left ventricular systolic dysfunction 3 . Although all mitral Doppler variables were independent predictor of PCWP, among mitral flow velocity indexes deceleration rate showed strongest correlation with PCWP followed by E/A ratio and deceleration time 4 .Several studies using both transoesophageal and transthoracic Doppler echocardiography have found close correlation between pulmonary venous flow variables and left ventricular filling pressures, suggesting that these variables may be more accurate predictorof filling pressure than are mitral flow variables [5][6][7] .Within pulmonary venous flow indices systolic fraction of peak velocities showed University Heart Journal Vol. AbstractThis prospective cross sectional study was conducted in the department of cardiology in National Institute of Cardiovascular Diseases (NICVD), Dhaka during the period of January 2002 to December 2002. A total of 50 patients with coronary artery disease subjected to diagnostic cardiac catheterization for evaluation of CAD were studied and the patients were grouped into two groups, group I having PCWP ≥12-<18 mmHg and group II having PCWP ≥18 mmHg. The aims of the study were to correlate the Pulmonary Capillary Wedge Pressure (PCWP) estimated by Doppler echocardiography with that obtained at cardiac catheterization. Among 2D and M mode echocardiographic indices it was observed that ejection fraction was significantly lower and maximal left atrial volume (MLAV) was significantly higher among patients having PCWP ≥18 mmHg (p<0.05). Among Doppler derived mitral flow variables deceleration rate was significantly higher (p<0.05) among patients having PCWP ≥18 mmHg. No statistically significant difference was found between two groups in terms of pulmonary venous flow variables. A statistically significant negative correlation of deceleration time (r=-0.483; p=0.001) and ejection fraction (r=-0.334; p=0.01) and a statistically significant positive correlation of peak E wave (r=0.345; p=0.01) and deceleration rate (r=0.651; p=0.001) was found with catheter derived PCWP. The correlation coefficient between measured and estimated PCWP (from equation 1) was (r=0.678) which was highest. When pulmonary ven...

Meta‐analysis of echocardiographic quantification of left ventricular filling pressure

“…A further 11 studies were identified through a thorough review of the referenced literature. After an initial screening of title and abstract, 34 research outcome papers were evaluated, and from these, 27 articles met the inclusion criteria 7–32 ( Figure ). The total number of patients studied across all the 27 studies was 2058.…”

“…and Gonzalez-Vilchez et al studied heterogeneous populations (n = 95), Ommen et al and Temporelli et al recruited HFrEF patients (n = 63), Ommen et al further studied 64 patients with HFpEF, and Tamanna et al investigated CAD (n = 50) [8][9][10]17,29. …”