Noninvasive prediction of the exercise-induced elevation in
left ventricular filling pressure in post-heart transplant
patients with normal left ventricular ejection fraction

J 2013

Noninvasive prediction of the exercise-induced elevation in left ventricular filling pressure in post-heart transplant patients with normal left ventricular ejection fraction

MELUZÍN, Jaroslav, Petr HUDE, Jan KREJČÍ, Lenka ŠPINAROVÁ, Helena PODROUŽKOVÁ et. al.

Basic information

Original name

Noninvasive prediction of the exercise-induced elevation in left ventricular filling pressure in post-heart transplant patients with normal left ventricular ejection fraction

Authors

MELUZÍN, Jaroslav (203 Czech Republic, guarantor, belonging to the institution), Petr HUDE (203 Czech Republic, belonging to the institution), Jan KREJČÍ (203 Czech Republic, belonging to the institution), Lenka ŠPINAROVÁ (203 Czech Republic, belonging to the institution), Helena PODROUŽKOVÁ (203 Czech Republic), Pavel LEINVEBER (203 Czech Republic), Ladislav DUŠEK (203 Czech Republic, belonging to the institution), Vladimír SOŠKA (203 Czech Republic), Josef TOMANDL (203 Czech Republic, belonging to the institution) and Petr NĚMEC (203 Czech Republic)

Edition

EXPERIMENTAL &CLINICAL CARDIOLOGY, OAKVILLE, PULSUS GROUP INC, 2013, 1205-6626

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 0.758

RIV identification code

RIV/00216224:14110/13:00069182

Organization unit

Faculty of Medicine

UT WoS

000322439400012

Keywords in English

Diastolic function; Exercise echocardiography; Pulmonary capillary wedge pressure

Abstract

V originále

OBJECTIVES: At present, there are conflicting data on the ability of echocardiographic parameters to predict the exercise-induced elevation of left ventricular (LV) filling pressure. The purpose of the present study was to validate the ratio of early diastolic transmitral (E) to mitral annular velocity (e') obtained at peak exercise in its capacity to determine the exercise-induced elevation of pulmonary capillary wedge pressure (PCWP) and to reveal new noninvasive parameters with such capacity. METHODS: Sixty-one patients who had undergone heart transplantation with normal LV ejection fraction underwent simultaneous exercise echocardiography and right heart catheterization. RESULTS: In 50 patients with a normal PCWP at rest, exercise E/e' >= 8.5 predicted exercise PCWP >= 25 mmHg with a sensitivity of 64.3% and a specificity of 84.2% (area under the curve [AUC]=0.74). A comparable or slightly better prediction was achieved by exercise E/peak systolic mitral annular velocity (s') >= 11.0 (sensitivity 79.3%; specificity 57.9%; AUC=0.75) and exercise E/LV systolic longitudinal strain rate <=-105 cm (sensitivity 78.9%; specificity 78.6%; AUC=0.87). Combined, exercise E/s' and exercise E/e' resulted in a trend toward a slightly more precise prediction (sensitivity 53.6%; specificity 89.5%; AUC=0.78) than did either variable alone. CONCLUSIONS: Exercise E/e', used as a sole parameter, is not sufficiently precise to predict the exercise-induced elevation of PCWP. Exercise E/s', E/LV systolic longitudinal strain rate or combinations of these parameters may represent further promising possibilities for predicting exercise PCWP elevation.

Citovat

MELUZÍN, Jaroslav, Petr HUDE, Jan KREJČÍ, Lenka ŠPINAROVÁ, Helena PODROUŽKOVÁ, Pavel LEINVEBER, Ladislav DUŠEK, Vladimír SOŠKA, Josef TOMANDL and Petr NĚMEC. Noninvasive prediction of the exercise-induced elevation in left ventricular filling pressure in post-heart transplant patients with normal left ventricular ejection fraction. EXPERIMENTAL &CLINICAL CARDIOLOGY. OAKVILLE: PULSUS GROUP INC, 2013, vol. 18, No 2, p. 63-72. ISSN 1205-6626.

@article{1121105,
   author = {Meluzín, Jaroslav and Hude, Petr and Krejčí, Jan and Špinarová, Lenka and Podroužková, Helena and Leinveber, Pavel and Dušek, Ladislav and Soška, Vladimír and Tomandl, Josef and Němec, Petr},
   article_location = {OAKVILLE},
   article_number = {2},
   keywords = {Diastolic function; Exercise echocardiography; Pulmonary capillary wedge pressure},
   language = {eng},
   issn = {1205-6626},
   journal = {EXPERIMENTAL &CLINICAL CARDIOLOGY},
   title = {Noninvasive prediction of the exercise-induced elevation in left ventricular filling pressure in post-heart transplant patients with normal left ventricular ejection fraction},
   volume = {18},
   year = {2013}
}

TY  - JOUR
ID  - 1121105
AU  - Meluzín, Jaroslav - Hude, Petr - Krejčí, Jan - Špinarová, Lenka - Podroužková, Helena - Leinveber, Pavel - Dušek, Ladislav - Soška, Vladimír - Tomandl, Josef - Němec, Petr
PY  - 2013
TI  - Noninvasive prediction of the exercise-induced elevation in left ventricular filling pressure in post-heart transplant patients with normal left ventricular ejection fraction
JF  - EXPERIMENTAL &CLINICAL CARDIOLOGY
VL  - 18
IS  - 2
SP  - 63-72
EP  - 63-72
PB  - PULSUS GROUP INC
SN  - 12056626
KW  - Diastolic function
KW  - Exercise echocardiography
KW  - Pulmonary capillary wedge pressure
N2  - OBJECTIVES: At present, there are conflicting data on the ability of echocardiographic parameters to predict the exercise-induced elevation of left ventricular (LV) filling pressure. The purpose of the present study was to validate the ratio of early diastolic transmitral (E) to mitral annular velocity (e') obtained at peak exercise in its capacity to determine the exercise-induced elevation of pulmonary capillary wedge pressure (PCWP) and to reveal new noninvasive parameters with such capacity. METHODS: Sixty-one patients who had undergone heart transplantation with normal LV ejection fraction underwent simultaneous exercise echocardiography and right heart catheterization. RESULTS: In 50 patients with a normal PCWP at rest, exercise E/e' >= 8.5 predicted exercise PCWP >= 25 mmHg with a sensitivity of 64.3% and a specificity of 84.2% (area under the curve [AUC]=0.74). A comparable or slightly better prediction was achieved by exercise E/peak systolic mitral annular velocity (s') >= 11.0 (sensitivity 79.3%; specificity 57.9%; AUC=0.75) and exercise E/LV systolic longitudinal strain rate <=-105 cm (sensitivity 78.9%; specificity 78.6%; AUC=0.87). Combined, exercise E/s' and exercise E/e' resulted in a trend toward a slightly more precise prediction (sensitivity 53.6%; specificity 89.5%; AUC=0.78) than did either variable alone. CONCLUSIONS: Exercise E/e', used as a sole parameter, is not sufficiently precise to predict the exercise-induced elevation of PCWP. Exercise E/s', E/LV systolic longitudinal strain rate or combinations of these parameters may represent further promising possibilities for predicting exercise PCWP elevation.
ER  -

MELUZÍN, Jaroslav, Petr HUDE, Jan KREJČÍ, Lenka ŠPINAROVÁ, Helena PODROUŽKOVÁ, Pavel LEINVEBER, Ladislav DUŠEK, Vladimír SOŠKA, Josef TOMANDL and Petr NĚMEC. Noninvasive prediction of the exercise-induced elevation in left ventricular filling pressure in post-heart transplant patients with normal left ventricular ejection fraction. \textit{EXPERIMENTAL \&{}CLINICAL CARDIOLOGY}. OAKVILLE: PULSUS GROUP INC, 2013, vol.~18, No~2, p.~63-72. ISSN~1205-6626.

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