4.5 Article

NOVEL ESTIMATION OF LEFT VENTRICULAR FILLING PRESSURE USING 3-D SPECKLE-TRACKING ECHOCARDIOGRAPHY: ASSESSMENT IN A DECOMPENSATED SYSTOLIC HEART FAILURE MODEL

Journal

ULTRASOUND IN MEDICINE AND BIOLOGY
Volume 47, Issue 6, Pages 1536-1547

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.ultrasmedbio.2021.02.008

Keywords

Filling pressure; Heart failure; Myocardial strain; Speckle-tracking echocardiography; Three-dimensional

Funding

  1. Canon Medical Systems

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The parameter FRe/SRe may provide a more accurate estimation of left ventricular filling pressure in dilated systolic failing hearts compared to E/e', as it can be obtained without the use of Doppler and showed higher correlation coefficients with LV end-diastolic pressure in a study involving dogs with decompensated heart failure.
E/e' allows for the non-invasive estimation of left ventricular (LV) filling pressure; however, Doppler malalignment can make the estimation unreliable, especially in dilated systolic failing hearts. The ratio of peak early diastolic filling rate to peak early diastolic global strain rate (FRe/SRe), which is a parameter derived from 3-D speckle-tracking echocardiography to estimate filling pressure, may be better applied in dilated systolic failing hearts because it can be obtained without the Doppler method. We investigated whether FRe/SRe could provide a better estimation of filling pressure than E/e' in 23 dogs with decompensated systolic heart failure induced by microembolization. FRe/SRe had better correlation coefficients with LV end-diastolic pressure (0.75-0.90) than did E/e' (0.40). The diagnostic accuracy of FRe/SRe in distinguishing elevated filling pressure was significantly higher than that of E/e'. This study indicates that FRe/SRe may provide a better estimation of LV filling pressure than E/e' in dilated systolic failing hearts. (C) 2021 The Author (s). Published by Elsevier Inc. on behalf of World Federation for Ultrasound in Medicine & Biology.

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