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To determine the correlation between echocardiographic diastolic parameters and invasively measured left ventricular
Awadhesh Kumar Sharma1, Hitender Kumar1, M M Razi1
1Department of Cardiology, LPS Institute of Cardiology, GSVM Medical College, Kanpur, UP, 208019, India.
Insights
Non-invasive echocardiographic parameters, specifically Lateral E/Ea ≥ 12, LAVI ≥34 mL/m2, and Ard-Ad > 30 msec, effectively diagnose diastolic dysfunction in HFpEF patients. These findings correlate well with invasive measurements, offering a safer alternative.
Area of Science:
- Cardiology
- Echocardiography
- Diastolic Dysfunction
Background:
- Invasive monitoring is accurate for diastolic dysfunction but carries risks.
- Non-invasive methods are sought for safer assessment of diastolic function.
Purpose of the Study:
- To establish correlations between non-invasive echocardiographic parameters and invasive measurements of left ventricular end-diastolic pressure (LVEDP).
- To identify reliable non-invasive markers for diagnosing diastolic dysfunction.
Main Methods:
- An observational, descriptive study involving 500 patients.
- Correlation analysis between echocardiographic diastolic parameters and invasively measured LVEDP.
- Assessed sensitivity and specificity of E/Ea for elevated LVEDP.
Main Results:
- Weak correlations were found for peak E velocity, Peak A velocity, IVRT, Mitral Deceleration Time, pulmonary venous peak systolic, and diastolic flows with LVEDP.
- Strong positive correlations were observed between elevated LVEDP and the difference in pulmonary venous and mitral flow at atrial contraction (A-Ard), and E/Ea.
- E/Ea < 8 showed 89% sensitivity and 90% specificity for detecting LVEDP > 12 mm Hg.
Conclusions:
- Lateral E/Ea ≥ 12, LAVI ≥34 mL/m2, and Ard-Ad > 30 msec are highly valuable for diagnosing diastolic dysfunction in heart failure with preserved ejection fraction (HFpEF) patients.
- These parameters demonstrate a good correlation with invasively measured LVEDP.
- These non-invasive markers provide a reliable and safer alternative for assessing diastolic dysfunction.
Objectives:
Though invasive monitoring is the most accurate to estimate diastolic dysfunction but it has its own risk. The purpose of this study was to find out any standardized correlation between invasive and non -invasive parameters.
Methods:
It is an observational, descriptive study comprising of a total of 500 patients. The primary objective of the study was to determine the correlation between echocardiographic diastolic parameters and invasively measured left ventricular end diastolic pressure (LVEDP).
Results:
On studying correlation of different invasive and non-invasive data it was reported that there was a weak correlation between peak E velocity (r = 0.14, p = 0.631), Peak A velocity (r = 0.67, p = 0.59), IVRT (r = -0.35, p = 0.178), Mitral deceleration time (DT) (r = -0.06, p = 0.842), pulmonary venous peak systolic (r = -0.02, p = 0.966) and diastolic flows (r = 0.47, p = 0.201) to LVEDP. There was a good positive correlation between elevated LVEDP and difference in duration of pulmonary venous and mitral flow at atrial contraction (A-Ard) and E/Ea at all four longitudinal segments of the left ventricle. The sensitivity and specificity for detecting an elevated LVEDP of more than 12 mm Hg, using a cut off value of E/Ea< 8, were 89% and 90%.Lateral E/Ea ≥ 12, LAVI ≥34 mL/m2, and Ard-Ad > 30 msec have the greatest diagnostic value for diagnosing diastolic dysfunction in HFpEF patients.
Conclusion:
Lateral E/Ea ≥ 12, LAVI ≥34 mL/m2, and Ard-Ad > 30 msec have the greatest diagnostic value for diagnosing diastolic dysfunction in HFpEF patients and have good correlation with invasively measured LVEDP.
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