title: Echocardiographic evaluation of hemodynamics in patients with decompensated systolic heart failure.
abstract: 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.
  
  
  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 (r=0.83, P<0.001), pulmonary artery systolic (r=0.83, P<0.001) and diastolic pressure (r=0.51, P=0.009), and mean right atrial pressure (r=0.85, P<0.001) 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, 91%) in identifying patients with increased wedge pressure. In 12 repeat studies, Doppler echocardiography readily detected the changes in mean wedge pressure (r=0.75, P=0.005) as well as changes in pulmonary artery systolic pressure and mean right atrial pressure.
  
  
  CONCLUSIONS
  Doppler echocardiography provides reliable assessment of right and left ventricular hemodynamics in patients with decompensated heart failure.
authors.affiliation: Methodist DeBakey Heart and Vascular Center, Houston, TX 77030, USA. snagueh@tmhs.org
authors.forename: Sherif F
authors.initials: SF
authors.lastname: Nagueh
authors.forename: Rajat
authors.initials: R
authors.lastname: Bhatt
authors.forename: Rey P
authors.initials: RP
authors.lastname: Vivo
authors.forename: Selim R
authors.initials: SR
authors.lastname: Krim
authors.forename: Sebastian Imre
authors.initials: SI
authors.lastname: Sarvari
authors.forename: Kristoffer
authors.initials: K
authors.lastname: Russell
authors.forename: Thor
authors.initials: T
authors.lastname: Edvardsen
authors.forename: Otto A
authors.initials: OA
authors.lastname: Smiseth
authors.forename: Jerry D
authors.initials: JD
authors.lastname: Estep
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity; D001794:Blood Pressure; D006328:Cardiac Catheterization; D002302:Cardiac Output; D002306:Cardiac Volume; D015150:Echocardiography, Doppler; D005260:Female; D054143:Heart Failure, Systolic / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011669:Pulmonary Wedge Pressure; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D016276:Ventricular Function; D055815:Young Adult