Echocardiographic evaluation of left ventricular end diastol
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This study aimed to evaluate the left ventricular end diastolic pressure (LVEDP) in patients with diastolic heart failure by echocardiography and explore the clinical value of echocardiography.

From July 2017 to January 2018, 120 patients were prospectively selected from the affiliated hospital of Jiangsu university diagnosed as diastolic heart failure (York Heart Association class greater than II, LVEF greater than 50%). The patients were divided into group with LVEDP less than 15 mm hg (43 cases) and the group with LVEDP greater than 15 mm hg (77 cases) according to the real-time measurement of LVEDP. Receiver operator characteristic curves of each parameter of echocardiography in diagnosis of LVEDP were compared between the 2 groups.

Common ultrasonic parameters such as left ventricular inflow tract blood flow propagation velocity, mitral valve diastole e peak velocity/mitral valve diastole a peak velocity, e peak deceleration time, a peak duration, and early diastole interventricular septum bicuspid annulus velocity e’ (e'sep) were used to evaluate LVEDP elevation with low accuracy (AUC is only between 0.5 and 0.7). Other ultrasonic parameters such as left atrial volume index (LAVI), tricuspid regurgitation maximum flow rate (TRmax), early diastole left ventricular sidewall bicuspid annulus velocity e’ (e’lat), average e’, E/e'sep, E/e’lat, average E/e’ were used to evaluate LVEDP elevation with a certain improvement in accuracy (AUC between 0.7 and 0.9).

Propagation velocity, mitral valve diastole e peak velocity/mitral valve diastole a peak velocity, e peak deceleration time, a peak duration, e'sep, average e’, E/e'sep have very low correlation with LVEDP; LAVI, TRmax, e’lat, E/e’lat, average E/e’ and LVEDP are not highly correlated. Through real-time left ventricular manometry, multiple regression analysis showed that TRmax, average e’, e’lat, LAVI were independently correlated with the actual measured LVEDP.

Echocardiography can recognize the increase of LVEDP in patients with heart failure preserved by LVEF, and estimate the value of LVEDP roughly, which can reflect LVEDP to a certain extent, with high feasibility and accuracy.

Source: https://journals.lww.com/md-journal/Fulltext/2020/12040/Echocardiographic_evaluation_of_left_ventricular.12.aspx
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