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Cited by 465Cardiovascular Function and Risk FactorsHeart Failure Treatment and ManagementHemodynamic Monitoring and Therapy

Optimal Noninvasive Assessment of Left Ventricular Filling Pressures: A Comparison of Tissue Doppler Echocardiography and B-Type Natriuretic Peptide in Patients With Pulmonary Artery Catheters

Dokainish, Hisham, Zoghbi, William A., Lakkis, Nasser M., Al-Bakshy, Faiz, Dhir, Meeney, Quinones, Miguel A., Nagueh, Sherif F.·2004·Circulation
DOI 10.1161/01.cir.0000127882.58426.7a
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Abstract

Background— Early transmitral velocity/tissue Doppler mitral annular early diastolic velocity (E/Ea) and B-type natriuretic peptide (BNP) have been correlated with left ventricular filling pressures, yet there are no data on how these 2 estimates of left ventricular filling pressures compare. Methods and Results— Patients admitted to intensive care underwent simultaneous tissue Doppler echocardiography, BNP measurement, and pulmonary capillary wedge pressure (PCWP) determination. The ability of mitral E/Ea and BNP to predict PCWP >15 mm Hg was assessed. Fifty patients were studied. Ln BNP had a correlation of r =0.32 ( P =0.02) with PCWP compared with r =0.69 ( P <0.001) between E/Ea and PCWP. E/Ea >15 was the optimal cutoff to predict PCWP >15 mm Hg (sensitivity, 86%; specificity, 88%), whereas the optimal BNP cutoff was >300 pg/mL (sensitivity, 91%; specificity, 56%). The correlation between change in PCWP and change in E/Ea at 48 hours was r =0.87 ( P =0.003) compared with r =−0.59 ( P =0.39) for BNP. In the 36 patients with cardiac disease, E/Ea >15 (sensitivity, 92%; specificity, 91%) appeared more accurate than BNP >400 pg/mL (sensitivity, 92%; specificity, 51%), whereas in patients without cardiac disease, BNP (sensitivity, 81%; specificity, 83%) appeared more accurate than E/Ea >15 (sensitivity, 74%; specificity, 72%) for PCWP >15 mm Hg. Conclusions— In intensive care unit patients, mitral E/Ea has a better correlation than BNP with PCWP. Both BNP and mitral E/Ea have high sensitivity for PCWP >15 mm Hg; however, E/Ea appears more specific in this patient population. In patients without cardiac disease, BNP appears more accurate than E/Ea for PCWP >15 mm Hg, whereas E/Ea appears more accurate in patients with cardiac disease.

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Crossref · 10.1161/01.cir.0000127882.58426.7a

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  • The ratio of the mitral E-wave velocity to the early diastolic mitral annular tissue velocity (E′) is a well validated index of pulmonary capillary wedge pressure.

    “The ratio of the mitral E-wave velocity to the early diastolic mitral annular tissue velocity (E′) is a well validated index of pulmonary capillary wedge pressure (87, 264).”

    From Cardiac remodeling in obesity (2008) · cites this paper as [87]

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Authors
Dokainish, H., Zoghbi, W. A., Lakkis, N. M., Al-Bakshy, F., Dhir, M., Quinones, M. A., & Nagueh, S. F.
Affiliations
  • Baylor College of Medicine (US)
  • Houston Methodist (US)
  • From Baylor College of Medicine, Houston, Tex.
ORCID
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2004-05-25
Volume
109
Issue
20
Pages
2432-2439
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/01.cir.0000127882.58426.7a
OpenAlex
W2023645565
Cited by
465
References
22
Citations by year
2026: 6 · 2025: 1 · 2024: 7 · 2023: 4 · 2022: 10 · 2021: 7 · 2020: 18 · 2019: 11 · 2018: 8 · 2017: 13 · 2016: 15 · 2015: 19 · 2014: 21 · 2013: 18 · 2012: 28
FWCI
24.73
Type
journal article
Language
en
Open access
closed
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
  • Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
Keywords
left ventricular filling pressure, tissue Doppler imaging, brain natriuretic peptide, pulmonary capillary wedge pressure, diastolic dysfunction, intensive care unit patients, diagnostic accuracy, heart disease
MeSH terms
Catheterization, Swan-Ganz, Female, Heart Diseases, Humans, Male, Middle Aged, Mitral Valve, Pulmonary Wedge Pressure, ROC Curve, Sensitivity and Specificity, Echocardiography, Doppler, Ventricular Pressure, Echocardiography, Doppler, Pulsed, Natriuretic Peptide, Brain

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