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Correlation with invasive left ventricular filling pressures and prognostic relevance of the echocardiographic diastolic parameters used in the 2016 ESC heart failure guidelines and in the 2016 ASE/EACVI recommendations: a systematic review in patients with heart failure with preserved ejection fraction.
Eur J Heart Fail. 2018 09; 20(9):1303-1311.EJ

Abstract

AIMS

Five echocardiographic parameters-left atrial volume index, left ventricular mass index, tricuspid regurgitation velocity, myocardial tissue velocity, and the ratio of early mitral inflow to tissue velocity of the mitral annulus (E/e')-are recommended in both the current European Society of Cardiology heart failure guidelines and the American Society of Echocardiography/European Association of Cardiovascular Imaging recommendations for the evaluation of left ventricular diastolic function. We aimed to perform a systematic review of these echocardiographic parameters at resting conditions for their correlation with left ventricular filling pressures in patients with heart failure with preserved ejection fraction (HFpEF). In addition, the prognostic value of these parameters was assessed.

METHODS AND RESULTS

Nine studies reported the correlation between echocardiography and invasive haemodynamics, and 18 papers reported on the prognostic value of echocardiography in HFpEF. Among the parameters, most data were reported for E/e'. The pooled correlation coefficient r was 0.56 for the relation between E/e' and invasively measured filling pressures. Combined weighted-mean meta-analysis of prognostic studies resulted in a hazard ratio of 1.05 (95% confidence interval 1.03-1.06) per unit increase in E/e' for the combined outcome of all-cause mortality and cardiovascular hospitalization. The other echocardiographic parameters, when taken individually, had similar or lower association with prognosis.

CONCLUSION

Only a small number of studies validated the use of echocardiographic parameters at rest in patients with HFpEF. The best established parameter appears to be E/e', but the existing data only show modest correlations of E/e' with invasive filling pressures and outcomes in HFpEF.

Authors+Show Affiliations

Department of Cardiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.Department of Cardiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.Department of Cardiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.Department of Cardiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands. Department of Cardiology, National Heart Centre Singapore, Duke-National University of Singapore, Singapore.Department of Cardiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.Department of Cardiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.

Pub Type(s)

Journal Article
Systematic Review

Language

eng

PubMed ID

29877602

Citation

Nauta, Jan F., et al. "Correlation With Invasive Left Ventricular Filling Pressures and Prognostic Relevance of the Echocardiographic Diastolic Parameters Used in the 2016 ESC Heart Failure Guidelines and in the 2016 ASE/EACVI Recommendations: a Systematic Review in Patients With Heart Failure With Preserved Ejection Fraction." European Journal of Heart Failure, vol. 20, no. 9, 2018, pp. 1303-1311.
Nauta JF, Hummel YM, van der Meer P, et al. Correlation with invasive left ventricular filling pressures and prognostic relevance of the echocardiographic diastolic parameters used in the 2016 ESC heart failure guidelines and in the 2016 ASE/EACVI recommendations: a systematic review in patients with heart failure with preserved ejection fraction. Eur J Heart Fail. 2018;20(9):1303-1311.
Nauta, J. F., Hummel, Y. M., van der Meer, P., Lam, C. S. P., Voors, A. A., & van Melle, J. P. (2018). Correlation with invasive left ventricular filling pressures and prognostic relevance of the echocardiographic diastolic parameters used in the 2016 ESC heart failure guidelines and in the 2016 ASE/EACVI recommendations: a systematic review in patients with heart failure with preserved ejection fraction. European Journal of Heart Failure, 20(9), 1303-1311. https://doi.org/10.1002/ejhf.1220
Nauta JF, et al. Correlation With Invasive Left Ventricular Filling Pressures and Prognostic Relevance of the Echocardiographic Diastolic Parameters Used in the 2016 ESC Heart Failure Guidelines and in the 2016 ASE/EACVI Recommendations: a Systematic Review in Patients With Heart Failure With Preserved Ejection Fraction. Eur J Heart Fail. 2018;20(9):1303-1311. PubMed PMID: 29877602.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Correlation with invasive left ventricular filling pressures and prognostic relevance of the echocardiographic diastolic parameters used in the 2016 ESC heart failure guidelines and in the 2016 ASE/EACVI recommendations: a systematic review in patients with heart failure with preserved ejection fraction. AU - Nauta,Jan F, AU - Hummel,Yoran M, AU - van der Meer,Peter, AU - Lam,Carolyn S P, AU - Voors,Adriaan A, AU - van Melle,Joost P, Y1 - 2018/06/07/ PY - 2017/11/30/received PY - 2018/04/10/revised PY - 2018/04/22/accepted PY - 2018/6/8/pubmed PY - 2019/2/9/medline PY - 2018/6/8/entrez KW - Echocardiography KW - Heart failure with preserved ejection fraction SP - 1303 EP - 1311 JF - European journal of heart failure JO - Eur. J. Heart Fail. VL - 20 IS - 9 N2 - AIMS: Five echocardiographic parameters-left atrial volume index, left ventricular mass index, tricuspid regurgitation velocity, myocardial tissue velocity, and the ratio of early mitral inflow to tissue velocity of the mitral annulus (E/e')-are recommended in both the current European Society of Cardiology heart failure guidelines and the American Society of Echocardiography/European Association of Cardiovascular Imaging recommendations for the evaluation of left ventricular diastolic function. We aimed to perform a systematic review of these echocardiographic parameters at resting conditions for their correlation with left ventricular filling pressures in patients with heart failure with preserved ejection fraction (HFpEF). In addition, the prognostic value of these parameters was assessed. METHODS AND RESULTS: Nine studies reported the correlation between echocardiography and invasive haemodynamics, and 18 papers reported on the prognostic value of echocardiography in HFpEF. Among the parameters, most data were reported for E/e'. The pooled correlation coefficient r was 0.56 for the relation between E/e' and invasively measured filling pressures. Combined weighted-mean meta-analysis of prognostic studies resulted in a hazard ratio of 1.05 (95% confidence interval 1.03-1.06) per unit increase in E/e' for the combined outcome of all-cause mortality and cardiovascular hospitalization. The other echocardiographic parameters, when taken individually, had similar or lower association with prognosis. CONCLUSION: Only a small number of studies validated the use of echocardiographic parameters at rest in patients with HFpEF. The best established parameter appears to be E/e', but the existing data only show modest correlations of E/e' with invasive filling pressures and outcomes in HFpEF. SN - 1879-0844 UR - https://www.unboundmedicine.com/medline/citation/29877602/Correlation_with_invasive_left_ventricular_filling_pressures_and_prognostic_relevance_of_the_echocardiographic_diastolic_parameters_used_in_the_2016_ESC_heart_failure_guidelines_and_in_the_2016_ASE/EACVI_recommendations:_a_systematic_review_in_patients_with_heart_failure_with_preserved_ejection_fraction_ L2 - https://doi.org/10.1002/ejhf.1220 DB - PRIME DP - Unbound Medicine ER -