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Echocardiographic e...
Echocardiographic estimation of pulmonary artery wedge pressure : invasive derivation, validation, and prognostic association beyond diastolic dysfunction grading
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- Lindow, Thomas (författare)
- Lund University,Lunds universitet,Andfåddhet och kronisk andningssvikt,Forskargrupper vid Lunds universitet,Breathlessness and chronic respiratory failure,Lund University Research Groups,University of Sydney,Växjö Central Hospital,Region Kronoberg
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- Manouras, Aristomenis (författare)
- Karolinska Institutet,Karolinska University Hospital
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- Lindqvist, Per (författare)
- Umeå University,Umeå universitet,Klinisk fysiologi
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- Manna, Daniel (författare)
- Department of Clinical Physiology, Växjö Central Hospital, Växjö, Sweden; Department of Research and Development, Region Kronoberg, Växjö, Sweden
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- Wieslander, Björn (författare)
- Karolinska Institutet,Karolinska University Hospital
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- Kozor, Rebecca (författare)
- Kolling Institute, Royal North Shore Hospital, University of Sydney, Kolling Building, St Leonards, Sydney, New South Wales, Australia
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- Strange, Geoff (författare)
- Institute for Health Research, School of Medicine, University of Notre Dame, Fremantle, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Heart Research Institute, Sydney, Australia; Royal Prince Alfred Hospital, Sydney, Australia
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- Playford, David (författare)
- Institute for Health Research, School of Medicine, University of Notre Dame, Fremantle, Australia
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- Ugander, Martin (författare)
- Karolinska Institutet,Karolinska University Hospital
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(creator_code:org_t)
- Oxford University Press, 2024
- 2024
- Engelska.
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Ingår i: European Heart Journal Cardiovascular Imaging. - : Oxford University Press. - 2047-2404 .- 2047-2412. ; 25:4, s. 498-509
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Abstract
Ämnesord
Stäng
- Background and aims: Grading of diastolic function can be useful, but indeterminate classifications are common.Objectives: We aimed to invasively derive and validate a quantitative echocardiographic estimation of pulmonary artery wedge pressure (PAWP), and to compare its prognostic performance to diastolic dysfunction grading.Methods: Echocardiographic measures were used to derive an estimated PAWP (ePAWP) using multivariable linear regression in patients undergoing right heart catheterization (RHC). Prognostic associations were analyzed in the National Echocardiography Database of Australia (NEDA).Results: In patients who had undergone both RHC and echocardiography within two hours (n=90), ePAWP was derived using left atrial volume index, mitral peak early velocity (E), and pulmonary vein systolic velocity (S). In a separate external validation cohort (n=53, simultaneous echocardiography and RHC), ePAWP showed good agreement with invasive PAWP (mean±SD difference 0.5±5.0 mmHg) and good diagnostic accuracy for estimating PAWP>15mmHg (area under the curve [95% confidence interval] 0.94 [0.88-1.00]). Among patients in NEDA (n=38,856, median [interquartile range] follow-up 4.8 [2.3-8.0] years, 2,756 cardiovascular deaths), ePAWP was associated with cardiovascular death even after adjustment for age, sex, and diastolic dysfunction grading (hazard ratio (HR) 1.08 [1.07-1.09] per mmHg) and provided incremental prognostic information to diastolic dysfunction grading (improved C-statistic from 0.65 to 0.68, p<0.001). Increased ePAWP was associated with worse prognosis across all grades of diastolic function (HR normal: 1.07 [1.06-1.09]; indeterminate: 1.08 [1.07-1.09]; abnormal: 1.08 [1.07-1.09], p<0.001 for all).Conclusions: Echocardiographic ePAWP is an easily acquired continuous variable with good accuracy that associates with prognosis beyond diastolic dysfunction grading.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- diastolic dysfunction
- echocardiography
- heart failure
- pulmonary capillary wedge pressure
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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