title: Noninvasive echocardiographic estimation of pulmonary wedge pressure in candidates for and recipients of heart transplantation.
abstract: OBJECTIVE
  We assessed the value of deceleration time (dt) of diastolic wave of pulmonary venous flow (PVF) (PVF_dt) as noninvasive estimation of pulmonary wedge pressure (PWP) in candidates for and recipients of heart transplantation.
  
  
  METHODS
  We prospectively recruited 51 patients with end-stage congestive heart failure (group A) and 49 recipients of heart transplantation (group B). PWP and PVF_dt were measured using a Swan-Ganz catheter and Doppler echocardiography, respectively. We performed regression analyses to assess interrelationships. Moreover, we used the area under the receiver operating characteristic curve to assess how clearly PVF_dt could discriminate between normal and elevated PWP values.
  
  
  RESULTS
  In both study groups, PWP was inversely associated with PVF_dt (R(2) = 0.785 and 0.797, respectively, P < .001). A cut-off value of less than 187 milliseconds was predictive of an elevated PWP value (> or =12 mm Hg) in both study groups. Specificity and sensitivity were between 90% and 100%, respectively, in both study groups. The area under the receiver operating characteristic curve was 0.961 (0.908-1.013; P < .001) for group A and 0.998 (0.992-1.04; P < .001) for group B.
  
  
  CONCLUSIONS
  In recipients of heart transplantation and patients with end-stage congestive heart failure, the noninvasive measuring of PVF_dt distinguishes between normal and elevated PWP values.
authors.affiliation: Department of Cardio-Thoracic Surgery, Heart Center North-Rhine Westfalia, Ruhr University of Bochum, Bad Oeynhausen, Germany. gtenderich@hdz-nrw.de <gtenderich@hdz-nrw.de>
authors.forename: Gero
authors.initials: G
authors.lastname: Tenderich
authors.forename: Adriana
authors.initials: A
authors.lastname: Olariu
authors.forename: Armin
authors.initials: A
authors.lastname: Zittermann
authors.forename: Ernst
authors.initials: E
authors.lastname: Wellnhofer
authors.forename: Heinrich
authors.initials: H
authors.lastname: Koertke
authors.forename: Reiner
authors.initials: R
authors.lastname: Koerfer
mesh_terms: D001783:Blood Flow Velocity; D006328:Cardiac Catheterization; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D011669:Pulmonary Wedge Pressure / Q000502:physiology*; D012372:ROC Curve; D012720:Severity of Illness Index