Reliability of echocardiography for hemodynamic assessment of end-stage heart failure.
The management of patients with end-stage heart failure is difficult and may require the monitoring of intracardiac pressures. The aim of this prospective study was to assess the reliability of echocardiography in patients with end-stage HF. Twenty consecutive patients presenting with severe left ventricular dysfunction in end-stage heart failure were prospectively studied. All patients underwent right-sided cardiac catheterization and transthoracic echocardiography. Right atrial pressure, estimated using a new echocardiographic parameter, was significantly improved. There was good agreement between systemic and pulmonary vascular resistance, determined by catheterization and echocardiography. All patients with echocardiographic pulmonary vascular resistance<6 Wood units also had invasive pulmonary vascular resistance<6 Wood units. Only echocardiographic mean right atrial pressure was related to the use of saline infusion or bolus infusion of furosemide. All patients requiring intravenous furosemide had pulmonary capillary wedge pressures persistently>or=15 mm Hg despite adequate medication. In conclusion, this study indicates that echocardiography may be a reliable tool for the management of patients with end-stage heart failure.
Mansencal
Nicolas
N
Department of Cardiology, University Hospital Ambroise Paré, Assistance Publique-Hôpitaux de Paris, UFR de Médecine Paris-Ile de France-Ouest, Faculté de Versailles-Saint Quentin en Yvelines, Boulogne, France. nicolas.mansencal@apr.aphp.fr
d'Allonnes
Laure Revault
LR
Beauchet
Alain
A
Fabre
Séverine
S
Digne
Franck
F
Farcot
Jean-Christian
JC
Joseph
Thierry
T
Dubourg
Olivier
O
D000328:Adult; D006328:Cardiac Catheterization; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011669:Pulmonary Wedge Pressure; D015203:Reproducibility of Results; D014463:Ultrasonography; D014655:Vascular Resistance; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*