Meta‐analysis of echocardiographic quantification of left ventricular filling pressure
Abstract Aims The clinical reliability of echocardiographic surrogate markers of left ventricular filling pressures (LVFPs) across different cardiovascular pathologies remains unanswered. The main objective was to evaluate the evidence of how effectively different echocardiographic indices estimate...
Main Authors: | , , , , , , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Wiley
2021-02-01
|
Series: | ESC Heart Failure |
Subjects: | |
Online Access: | https://doi.org/10.1002/ehf2.13119 |
id |
doaj-8e5e5689c13e48bdbb1f90fe8e1ed84a |
---|---|
record_format |
Article |
spelling |
doaj-8e5e5689c13e48bdbb1f90fe8e1ed84a2021-03-31T03:15:45ZengWileyESC Heart Failure2055-58222021-02-018156657610.1002/ehf2.13119Meta‐analysis of echocardiographic quantification of left ventricular filling pressureRachel Jones0Frances Varian1Samer Alabed2Paul Morris3Alexander Rothman4Andrew J. Swift5Nigel Lewis6Andreas Kyriacou7James M. Wild8Abdallah Al‐Mohammad9Liang Zhong10Amardeep Dastidar11Robert F. Storey12Peter P. Swoboda13Jeroen J. Bax14Pankaj Garg15Department of Infection, Immunity and Cardiovascular Disease The University of Sheffield Sheffield S10 2RX UKDepartment of Infection, Immunity and Cardiovascular Disease The University of Sheffield Sheffield S10 2RX UKDepartment of Infection, Immunity and Cardiovascular Disease The University of Sheffield Sheffield S10 2RX UKDepartment of Infection, Immunity and Cardiovascular Disease The University of Sheffield Sheffield S10 2RX UKDepartment of Infection, Immunity and Cardiovascular Disease The University of Sheffield Sheffield S10 2RX UKDepartment of Infection, Immunity and Cardiovascular Disease The University of Sheffield Sheffield S10 2RX UKDepartment of Cardiology Sheffield Teaching Hospitals NHS Foundation Trust Sheffield UKDepartment of Cardiology Sheffield Teaching Hospitals NHS Foundation Trust Sheffield UKDepartment of Infection, Immunity and Cardiovascular Disease The University of Sheffield Sheffield S10 2RX UKDepartment of Infection, Immunity and Cardiovascular Disease The University of Sheffield Sheffield S10 2RX UKNational Heart Research Institute Singapore National Heart Centre Singapore SingaporeBristol Heart Institute Bristol UKDepartment of Infection, Immunity and Cardiovascular Disease The University of Sheffield Sheffield S10 2RX UKLeeds Institute of Cardiovascular and Metabolic Medicine University of Leeds Leeds UKCardiology Directorate Leiden University Medical Centre Leiden The NetherlandsDepartment of Infection, Immunity and Cardiovascular Disease The University of Sheffield Sheffield S10 2RX UKAbstract Aims The clinical reliability of echocardiographic surrogate markers of left ventricular filling pressures (LVFPs) across different cardiovascular pathologies remains unanswered. The main objective was to evaluate the evidence of how effectively different echocardiographic indices estimate true LVFP. Methods and results Design: this is a systematic review and meta‐analysis. Data source: Scopus, PubMed and Embase. Eligibility criteria for selecting studies were those that used echocardiography to predict or estimate pulmonary capillary wedge pressure or left ventricular end‐diastolic pressures. Twenty‐seven studies met criteria. Only eight studies (30%) reported both correlation coefficient and bias between non‐invasive and invasively measured LVFPs. The majority of studies (74%) recorded invasive pulmonary capillary wedge pressure as a surrogate for left ventricular end‐diastolic pressures. The pooled correlation coefficient overall was r = 0.69 [95% confidence interval (CI) 0.63–0.75, P < 0.01]. Evaluation by cohort demonstrated varying association: heart failure with preserved ejection fraction (11 studies, n = 575, r = 0.59, 95% CI 0.53–0.64) and heart failure with reduced ejection fraction (8 studies, n = 381, r = 0.67, 95% CI 0.61–0.72). Conclusions Echocardiographic indices show moderate pooled association to invasively measured LVFP; however, this varies widely with disease state. In heart failure with preserved ejection fraction, no single echocardiography‐based metric offers a reliable estimate. In heart failure with reduced ejection fraction, mitral inflow‐derived indices (E/e′, E/A, E/Vp, and EDcT) have reasonable clinical applicability. While an integrated approach of several echocardiographic metrics provides the most promise for estimating LVFP reliably, such strategies need further validation in larger, patient‐specific studies.https://doi.org/10.1002/ehf2.13119Left ventricular end‐diastolic pressureEchocardiographyInvasive heart catheterization |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Rachel Jones Frances Varian Samer Alabed Paul Morris Alexander Rothman Andrew J. Swift Nigel Lewis Andreas Kyriacou James M. Wild Abdallah Al‐Mohammad Liang Zhong Amardeep Dastidar Robert F. Storey Peter P. Swoboda Jeroen J. Bax Pankaj Garg |
spellingShingle |
Rachel Jones Frances Varian Samer Alabed Paul Morris Alexander Rothman Andrew J. Swift Nigel Lewis Andreas Kyriacou James M. Wild Abdallah Al‐Mohammad Liang Zhong Amardeep Dastidar Robert F. Storey Peter P. Swoboda Jeroen J. Bax Pankaj Garg Meta‐analysis of echocardiographic quantification of left ventricular filling pressure ESC Heart Failure Left ventricular end‐diastolic pressure Echocardiography Invasive heart catheterization |
author_facet |
Rachel Jones Frances Varian Samer Alabed Paul Morris Alexander Rothman Andrew J. Swift Nigel Lewis Andreas Kyriacou James M. Wild Abdallah Al‐Mohammad Liang Zhong Amardeep Dastidar Robert F. Storey Peter P. Swoboda Jeroen J. Bax Pankaj Garg |
author_sort |
Rachel Jones |
title |
Meta‐analysis of echocardiographic quantification of left ventricular filling pressure |
title_short |
Meta‐analysis of echocardiographic quantification of left ventricular filling pressure |
title_full |
Meta‐analysis of echocardiographic quantification of left ventricular filling pressure |
title_fullStr |
Meta‐analysis of echocardiographic quantification of left ventricular filling pressure |
title_full_unstemmed |
Meta‐analysis of echocardiographic quantification of left ventricular filling pressure |
title_sort |
meta‐analysis of echocardiographic quantification of left ventricular filling pressure |
publisher |
Wiley |
series |
ESC Heart Failure |
issn |
2055-5822 |
publishDate |
2021-02-01 |
description |
Abstract Aims The clinical reliability of echocardiographic surrogate markers of left ventricular filling pressures (LVFPs) across different cardiovascular pathologies remains unanswered. The main objective was to evaluate the evidence of how effectively different echocardiographic indices estimate true LVFP. Methods and results Design: this is a systematic review and meta‐analysis. Data source: Scopus, PubMed and Embase. Eligibility criteria for selecting studies were those that used echocardiography to predict or estimate pulmonary capillary wedge pressure or left ventricular end‐diastolic pressures. Twenty‐seven studies met criteria. Only eight studies (30%) reported both correlation coefficient and bias between non‐invasive and invasively measured LVFPs. The majority of studies (74%) recorded invasive pulmonary capillary wedge pressure as a surrogate for left ventricular end‐diastolic pressures. The pooled correlation coefficient overall was r = 0.69 [95% confidence interval (CI) 0.63–0.75, P < 0.01]. Evaluation by cohort demonstrated varying association: heart failure with preserved ejection fraction (11 studies, n = 575, r = 0.59, 95% CI 0.53–0.64) and heart failure with reduced ejection fraction (8 studies, n = 381, r = 0.67, 95% CI 0.61–0.72). Conclusions Echocardiographic indices show moderate pooled association to invasively measured LVFP; however, this varies widely with disease state. In heart failure with preserved ejection fraction, no single echocardiography‐based metric offers a reliable estimate. In heart failure with reduced ejection fraction, mitral inflow‐derived indices (E/e′, E/A, E/Vp, and EDcT) have reasonable clinical applicability. While an integrated approach of several echocardiographic metrics provides the most promise for estimating LVFP reliably, such strategies need further validation in larger, patient‐specific studies. |
topic |
Left ventricular end‐diastolic pressure Echocardiography Invasive heart catheterization |
url |
https://doi.org/10.1002/ehf2.13119 |
work_keys_str_mv |
AT racheljones metaanalysisofechocardiographicquantificationofleftventricularfillingpressure AT francesvarian metaanalysisofechocardiographicquantificationofleftventricularfillingpressure AT sameralabed metaanalysisofechocardiographicquantificationofleftventricularfillingpressure AT paulmorris metaanalysisofechocardiographicquantificationofleftventricularfillingpressure AT alexanderrothman metaanalysisofechocardiographicquantificationofleftventricularfillingpressure AT andrewjswift metaanalysisofechocardiographicquantificationofleftventricularfillingpressure AT nigellewis metaanalysisofechocardiographicquantificationofleftventricularfillingpressure AT andreaskyriacou metaanalysisofechocardiographicquantificationofleftventricularfillingpressure AT jamesmwild metaanalysisofechocardiographicquantificationofleftventricularfillingpressure AT abdallahalmohammad metaanalysisofechocardiographicquantificationofleftventricularfillingpressure AT liangzhong metaanalysisofechocardiographicquantificationofleftventricularfillingpressure AT amardeepdastidar metaanalysisofechocardiographicquantificationofleftventricularfillingpressure AT robertfstorey metaanalysisofechocardiographicquantificationofleftventricularfillingpressure AT peterpswoboda metaanalysisofechocardiographicquantificationofleftventricularfillingpressure AT jeroenjbax metaanalysisofechocardiographicquantificationofleftventricularfillingpressure AT pankajgarg metaanalysisofechocardiographicquantificationofleftventricularfillingpressure |
_version_ |
1724178637880557568 |