Related Experiment Videos
Echocardiographic evaluation of hemodynamics in patients with decompensated systolic heart failure
Sherif F Nagueh1, Rajat Bhatt, Rey P Vivo
1Methodist DeBakey Heart and Vascular Center, Houston, TX 77030, USA. snagueh@tmhs.org
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.
Related Concept Videos
Imaging Studies for Cardiovascular System I:Echocardiography
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion, evaluates...
Heart Failure II: Pathophysiology
Heart Failure V: Medical Management
Imaging Studies for Cardiovascular System II:Types of Echocardiography
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for diagnosing...
Acute Coronary Syndrome III: Diagnostic Studies
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies