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Invasive validation of the left ventricular global longitudinal strain for estimating left ventricular filling pressure
Author(s) -
Tan Turkan Seda,
Turan Serifler Nazli,
Demirtola Ayse Irem,
Akbulut Irem Muge,
Ozyuncu Nil,
Vurgun Veysel Kutay,
Esenboga Kerim,
Kurklu Haci Ali,
Kozluca Volkan,
Gerede Uludag Demet Menekse,
Ongun Aydan,
Dincer Irem
Publication year - 2021
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.15127
Subject(s) - medicine , cardiology , ejection fraction , ventricular filling , left atrial pressure , cardiac catheterization , heart failure , blood pressure , nuclear medicine , diastole
Purpose An elevated left ventricular (LV) filling pressure is the main finding in heart failure patients with preserved ejection fraction, which is estimated with an algorithm using echocardiographic parameters recommended by the recent American Society of Echocardiography (ASE)/European Association of Cardiovascular Imaging (EACVI) guidelines. In this study, we sought to determine the efficacy of the LV global longitudinal strain (GLS) in predicting an elevated LV filling pressure. Methods and Results A total of 73 prospectively selected patients undergoing LV catheterization (mean age 63.19 ± 9.64, 69% male) participated in this study. Using the algorithm, the LV filling pressure was estimated using the echocardiographic parameters obtained within 24 hours before catheterization. The LV GLS was measured using an automated functional imaging system (GE, Vivid E9 USA). Invasive LV pre‐A pressure corresponding to the mean left atrial pressure (LAP) was used as a reference, and a LAP of >12 mm Hg was defined as elevated. Invasive LV filling pressure was elevated in 43 patients (59%) and normal in 30 patients (41%). Nine of 73 (12%) patients were defined as indeterminate based on the 2016 algorithm. Using the ROC method, −18.1% of LV GLS determined the elevated LAP (AUC =0.79; specificity, 73%; sensitivity, 84%) with better sensitivity compared to that by the algorithm (AUC =0.76; specificity, 77%; sensitivity, 72%). Conclusions We demonstrated that LV GLS was an independent predictor of elevated LAP as the E/e’ ratio and TR jet velocity and may be used as a major criterion for the diagnosis of HFpEF.