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Echocardiographic Evaluation of Hemodynamics in Patients With Decompensated Systolic Heart Failure Sherif F. Nagueh, MD; Rajat Bhatt, MD; Rey P. Vivo, MD; Selim R. Krim, MD; Sebastian Imre Sarvari, MD; Kristoffer Russell, MD; Thor Edvardsen, MD, PhD; Otto A. Smiseth, MD, PhD; Jerry D. Estep, MD Background—Doppler echocardiography is currently applied for the assessment of left ventricular and right ventricular hemodynamics in patients with cardiovascular disease. However, there are conflicting reports about its accuracy in patients with unstable decompensated heart failure. The objective of this study was to evaluate the accuracy of the technique in patients with unstable heart failure. Methods and Results—Consecutive patients with decompensated heart failure had simultaneous assessment of left ventricular and right ventricular hemodynamics invasively and by Doppler echocardiography. In 79 patients, the noninvasive measurements of stroke volume (r0.83, P0.001), pulmonary artery systolic (r0.83, P0.001) and diastolic pressure (r0.51, P0.009), and mean right atrial pressure (r0.85, P0.001) all had significant correlations with invasively acquired measurements. Several Doppler indices had good accuracy in identifying patients with pulmonary capillary wedge pressure 15 mm Hg (area under the curve, 0.86 to 0.92). The recent American Society of Echocardiography/European Association of Echocardiography guidelines were highly accurate (sensitivity, 98%; specificity,
Circulation: Cardiovascular Imaging – Wolters Kluwer Health
Published: May 1, 2011
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