Accurate noninvasive estimation of left ventricular end-diastolic pressure: comparison with catheterization.
We evaluated the accuracy of a new Doppler-based method using the mitral regurgitant velocity at the time of aortic valve opening for the noninvasive estimation of left ventricular end-diastolic pressure. Sixty unselected patients were studied immediately before routine catheterization. Invasive left ventricular end-diastolic pressure was obtained using a fluid-filled pig-tail catheter. Noninvasive estimation of left ventricular pressure at aortic valve opening was taken as systemic diastolic pressure using an automated cuff. Noninvasive left ventricular end-diastolic pressure was calculated as diastolic blood pressure--4 x (mitral regurgitant velocity at aortic opening)2. Those making noninvasive determinations were blinded to catheterization results. An adequate mitral regurgitant Doppler recording was obtained in 24 patients (40%). In patients with a left ventricular end-diastolic pressure greater than 15 mm Hg the yield was 65%. Left ventricular end-diastolic pressures ranged from 4 mm Hg to 30 mm Hg. Bland and Altman analysis revealed no systematic bias and close agreement was found, with individual discrepancies not exceeding 5 mm Hg.
Neumann
A
A
Department of Medicine, Rush-Presbyterian-St. Luke's Medical Center, Rush Medical College, Chicago, Illinois 60612, USA.
Soble
J S
JS
Anagnos
P C
PC
Kagzi
M
M
Parrillo
J E
JE
D001794:Blood Pressure; D006328:Cardiac Catheterization; D003971:Diastole; D015150:Echocardiography, Doppler; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging; D015588:Observer Variation; D016277:Ventricular Function, Left; D017725:Ventricular Pressure