Doppler echocardiography reliably predicts pulmonary artery wedge pressure in patients with chronic heart failure with and without mitral regurgitation

Massimo Pozzoli, Soccorso Capomolla, Gianni Pinna, Franco Cobelli, Luigi Tavazzi

Research output: Contribution to journalArticle

128 Citations (Scopus)

Abstract

Objectives. This study was performed to assess whether the combination of multiple echocardiographic and Doppler variables can provide a reliable estimation of pulmonary artery wedge pressure in patients with chronic heart failure. Backgroud. In patients with chronic heart failure a high pulmonary artery wedge pressure is associated with poor prognosis, more severe symptoms and low exercise tolerance. Several Doppler echocardiographic indexes have been shown to be related to pulmonary artery wedge pressure, but the dispersion of data has generally not allowed a quantitative assessment of this important variable. Methods. Simultaneous Doppler echocardiographic examinations and right heart catheterizations were performed in 231 patients with chronic heart failure due to dilated cardiomyopathy. Mitral and pulmonary venous flow velocity variables, left atrial volumes, mitral resurgitation jet area and left ventricular ejection fraction were correlated with pulmonary artery wedge pressure by both single and multilinear regression analysis. The reliability of the obtained multilinear equations was then tested in a separate group of 60 patients. Results. By univariate analysis, the deceleration rate of early diastolic mitral flow and the systolic fraction of pulmonary venous how showed the strongest correlations (r = 0.78 and = -0.76; respectively). Stepwise regression analysis led to two multilinear equations for predicting pulmonary artery wedge pressure in the whole population: the first included only two dimensional echocardiographic and mitral flow velocity variables (r = 0.84) and the second also included pulmonary venous flow variables (r = 0.87). The highest correlation was obtained (r = 0.89) by a third equation in the 73 patients without significant mitral regurgita tion. Correlation coefficients between estimated and measured pulmonary artery wedge pressure were 0.91 (SEE = 2.7 mm Hg) and 0.97 (SEE 1.8 mm Hg) when the first and the second equation, respectively, were applied to the testing group. Conclusions. These results indicate that, in patients with chronic heart failure due to dilated cardiomyopathy, pulmonary artery wedge pressure can be reliably estimated even when mitral regurgitation is present by combining Doppler echocardiographic variables of mitral and pulmonary venous flow.

Original languageEnglish
Pages (from-to)883-893
Number of pages11
JournalJournal of the American College of Cardiology
Volume27
Issue number4
DOIs
Publication statusPublished - Mar 15 1996

Fingerprint

Pulmonary Wedge Pressure
Doppler Echocardiography
Mitral Valve Insufficiency
Heart Failure
Lung
Dilated Cardiomyopathy
Regression Analysis
Exercise Tolerance
Deceleration
Cardiac Catheterization
Stroke Volume
Population

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Doppler echocardiography reliably predicts pulmonary artery wedge pressure in patients with chronic heart failure with and without mitral regurgitation. / Pozzoli, Massimo; Capomolla, Soccorso; Pinna, Gianni; Cobelli, Franco; Tavazzi, Luigi.

In: Journal of the American College of Cardiology, Vol. 27, No. 4, 15.03.1996, p. 883-893.

Research output: Contribution to journalArticle

@article{fa0f01d981e642058690655ba38e13ea,
title = "Doppler echocardiography reliably predicts pulmonary artery wedge pressure in patients with chronic heart failure with and without mitral regurgitation",
abstract = "Objectives. This study was performed to assess whether the combination of multiple echocardiographic and Doppler variables can provide a reliable estimation of pulmonary artery wedge pressure in patients with chronic heart failure. Backgroud. In patients with chronic heart failure a high pulmonary artery wedge pressure is associated with poor prognosis, more severe symptoms and low exercise tolerance. Several Doppler echocardiographic indexes have been shown to be related to pulmonary artery wedge pressure, but the dispersion of data has generally not allowed a quantitative assessment of this important variable. Methods. Simultaneous Doppler echocardiographic examinations and right heart catheterizations were performed in 231 patients with chronic heart failure due to dilated cardiomyopathy. Mitral and pulmonary venous flow velocity variables, left atrial volumes, mitral resurgitation jet area and left ventricular ejection fraction were correlated with pulmonary artery wedge pressure by both single and multilinear regression analysis. The reliability of the obtained multilinear equations was then tested in a separate group of 60 patients. Results. By univariate analysis, the deceleration rate of early diastolic mitral flow and the systolic fraction of pulmonary venous how showed the strongest correlations (r = 0.78 and = -0.76; respectively). Stepwise regression analysis led to two multilinear equations for predicting pulmonary artery wedge pressure in the whole population: the first included only two dimensional echocardiographic and mitral flow velocity variables (r = 0.84) and the second also included pulmonary venous flow variables (r = 0.87). The highest correlation was obtained (r = 0.89) by a third equation in the 73 patients without significant mitral regurgita tion. Correlation coefficients between estimated and measured pulmonary artery wedge pressure were 0.91 (SEE = 2.7 mm Hg) and 0.97 (SEE 1.8 mm Hg) when the first and the second equation, respectively, were applied to the testing group. Conclusions. These results indicate that, in patients with chronic heart failure due to dilated cardiomyopathy, pulmonary artery wedge pressure can be reliably estimated even when mitral regurgitation is present by combining Doppler echocardiographic variables of mitral and pulmonary venous flow.",
author = "Massimo Pozzoli and Soccorso Capomolla and Gianni Pinna and Franco Cobelli and Luigi Tavazzi",
year = "1996",
month = "3",
day = "15",
doi = "10.1016/0735-1097(95)00553-6",
language = "English",
volume = "27",
pages = "883--893",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "4",

}

TY - JOUR

T1 - Doppler echocardiography reliably predicts pulmonary artery wedge pressure in patients with chronic heart failure with and without mitral regurgitation

AU - Pozzoli, Massimo

AU - Capomolla, Soccorso

AU - Pinna, Gianni

AU - Cobelli, Franco

AU - Tavazzi, Luigi

PY - 1996/3/15

Y1 - 1996/3/15

N2 - Objectives. This study was performed to assess whether the combination of multiple echocardiographic and Doppler variables can provide a reliable estimation of pulmonary artery wedge pressure in patients with chronic heart failure. Backgroud. In patients with chronic heart failure a high pulmonary artery wedge pressure is associated with poor prognosis, more severe symptoms and low exercise tolerance. Several Doppler echocardiographic indexes have been shown to be related to pulmonary artery wedge pressure, but the dispersion of data has generally not allowed a quantitative assessment of this important variable. Methods. Simultaneous Doppler echocardiographic examinations and right heart catheterizations were performed in 231 patients with chronic heart failure due to dilated cardiomyopathy. Mitral and pulmonary venous flow velocity variables, left atrial volumes, mitral resurgitation jet area and left ventricular ejection fraction were correlated with pulmonary artery wedge pressure by both single and multilinear regression analysis. The reliability of the obtained multilinear equations was then tested in a separate group of 60 patients. Results. By univariate analysis, the deceleration rate of early diastolic mitral flow and the systolic fraction of pulmonary venous how showed the strongest correlations (r = 0.78 and = -0.76; respectively). Stepwise regression analysis led to two multilinear equations for predicting pulmonary artery wedge pressure in the whole population: the first included only two dimensional echocardiographic and mitral flow velocity variables (r = 0.84) and the second also included pulmonary venous flow variables (r = 0.87). The highest correlation was obtained (r = 0.89) by a third equation in the 73 patients without significant mitral regurgita tion. Correlation coefficients between estimated and measured pulmonary artery wedge pressure were 0.91 (SEE = 2.7 mm Hg) and 0.97 (SEE 1.8 mm Hg) when the first and the second equation, respectively, were applied to the testing group. Conclusions. These results indicate that, in patients with chronic heart failure due to dilated cardiomyopathy, pulmonary artery wedge pressure can be reliably estimated even when mitral regurgitation is present by combining Doppler echocardiographic variables of mitral and pulmonary venous flow.

AB - Objectives. This study was performed to assess whether the combination of multiple echocardiographic and Doppler variables can provide a reliable estimation of pulmonary artery wedge pressure in patients with chronic heart failure. Backgroud. In patients with chronic heart failure a high pulmonary artery wedge pressure is associated with poor prognosis, more severe symptoms and low exercise tolerance. Several Doppler echocardiographic indexes have been shown to be related to pulmonary artery wedge pressure, but the dispersion of data has generally not allowed a quantitative assessment of this important variable. Methods. Simultaneous Doppler echocardiographic examinations and right heart catheterizations were performed in 231 patients with chronic heart failure due to dilated cardiomyopathy. Mitral and pulmonary venous flow velocity variables, left atrial volumes, mitral resurgitation jet area and left ventricular ejection fraction were correlated with pulmonary artery wedge pressure by both single and multilinear regression analysis. The reliability of the obtained multilinear equations was then tested in a separate group of 60 patients. Results. By univariate analysis, the deceleration rate of early diastolic mitral flow and the systolic fraction of pulmonary venous how showed the strongest correlations (r = 0.78 and = -0.76; respectively). Stepwise regression analysis led to two multilinear equations for predicting pulmonary artery wedge pressure in the whole population: the first included only two dimensional echocardiographic and mitral flow velocity variables (r = 0.84) and the second also included pulmonary venous flow variables (r = 0.87). The highest correlation was obtained (r = 0.89) by a third equation in the 73 patients without significant mitral regurgita tion. Correlation coefficients between estimated and measured pulmonary artery wedge pressure were 0.91 (SEE = 2.7 mm Hg) and 0.97 (SEE 1.8 mm Hg) when the first and the second equation, respectively, were applied to the testing group. Conclusions. These results indicate that, in patients with chronic heart failure due to dilated cardiomyopathy, pulmonary artery wedge pressure can be reliably estimated even when mitral regurgitation is present by combining Doppler echocardiographic variables of mitral and pulmonary venous flow.

UR - http://www.scopus.com/inward/record.url?scp=0029919485&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029919485&partnerID=8YFLogxK

U2 - 10.1016/0735-1097(95)00553-6

DO - 10.1016/0735-1097(95)00553-6

M3 - Article

VL - 27

SP - 883

EP - 893

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 4

ER -