CIRCIMAGING.111.963496
Echocardiographic Evaluation of Hemodynamics in Patients with Decompensated Systolic Heart Failure
- Sherif Nagueh1*,
- Rajat Bhatt1,
- Ray P. Vivo1,
- Selim R. Krim1,
- Sebastian Imre Sarvari2,
- Kristoffer Russell2,
- Thor Edvardsen2,
- Otto A. Smiseth2 and
- Jerry D. Estep
Abstract
Background—Doppler echocardiography is currently applied for the assessment of left ventricular (LV) and right ventricular (RV) 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 LV and RV hemodynamics invasively and by Doppler echocardiography. In 79 patients, the non-invasive measurements of stroke volume (r=0.83, p<0.001), r="0.83," r="0.51," p="0.009)," r="0.85,">15 mmHg (AUC from 0.86 to 0.92). The recent ASE/EAE 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 LV hemodynamics in patients with decompensated heart failure.
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