Echocardiographic evaluation of hemodynamics in patients with decompensated systolic heart failure

Sherif F. Nagueh, Rajat Bhatt, Rey P. Vivo, Selim R. Krim, Sebastian Imre Sarvari, Kristoffer Russell, Thor Edvardsen, Otto A. Smiseth, Jerry D. Estep

Research output: Contribution to journalArticle

110 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)220-227
Number of pages8
JournalCirculation: Cardiovascular Imaging
Volume4
Issue number3
DOIs
StatePublished - May 2011

Keywords

  • Diastole
  • Doppler
  • Echocardiography
  • Heart failure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

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