title: European multicentre validation study of the accuracy of E/e' ratio in estimating invasive left ventricular filling pressure: EURO-FILLING study.
abstract: OBJECTIVE
  The non-invasive estimation of left ventricular filling pressures (LVFPs) represents a main goal in the clinical setting. Current recommendations encourage the use of pulsed-wave Tissue Doppler for calculating the ratio between the preload-dependent transmitral E velocity and the average of septal and lateral early diastolic velocities (e') of the mitral annulus. Despite its wide use, real utility of the E/e' ratio has been recently challenged in patients with either very advanced heart failure or preserved left ventricular (LV) ejection fraction. However, only few studies performed the invasive and non-invasive estimation of LVFP simultaneously. The EURO-FILLING Study will validate the E/e' ratio (and additional non-invasive estimates) against simultaneously measured LVFP obtained by left heart catheterization in a multicentre study involving reference European echo laboratories collecting a wide population sample size of cardiac patients with and without heart failure.
  
  
  RESULTS
  The EURO-FILLING study is a large, prospective observational study in which simultaneous assessment of invasive and non-invasive measurements of LVFP will be acquired in eight reference European centres. Centralized reading of the collected parameters will be performed in a core laboratory. Not only standardized echo Doppler measurements but also novel echo parameters such as LV global longitudinal strain and global atrial strain (obtainable by two-dimensional speckle tracking echocardiography) will be tested for predicting invasive measurements of LVFP.
  
  
  CONCLUSIONS
  The EURO-FILLING study is expected to provide important information on non-invasive assessment of LVFP and to contribute to the standardization of this assessment in clinical practice.
authors.affiliation: Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy mgalderi@unina.it.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Galderisi
authors.affiliation: Department of Cardiology, GIGA Cardiovascular Sciences, Heart Valve Clinic, University of Liège Hospital, Belgium.
authors.forename: Patrizio
authors.initials: P
authors.lastname: Lancellotti
authors.affiliation: Department of Cardiology, Hospital Pontchaillou-University Medical Center, Rennes, France.
authors.forename: Erwan
authors.initials: E
authors.lastname: Donal
authors.affiliation: Cardiology Department, Hospital da Luz, Lisbon, Portugal.
authors.forename: Nuno
authors.initials: N
authors.lastname: Cardim
authors.affiliation: Department of Cardiology, Oslo University Hospital, Norway.
authors.forename: Thor
authors.initials: T
authors.lastname: Edvardsen
authors.affiliation: Cardiology Department, Hospital La Timone, Marseille, France.
authors.forename: Gilbert
authors.initials: G
authors.lastname: Habib
authors.affiliation: Department of Cardiology, GIGA Cardiovascular Sciences, Heart Valve Clinic, University of Liège Hospital, Belgium.
authors.forename: Julien
authors.initials: J
authors.lastname: Magne
authors.affiliation: Division of Cardiology, Second Department of Medicine, Medical University of Vienna, Austria.
authors.forename: Gerald
authors.initials: G
authors.lastname: Maurer
authors.affiliation: 'Carol Davila' University of Medicine and Pharmacy-Euroecolab, Institute of Cardiovascular Diseases, Bucharest, Romania.
authors.forename: Bogdan A
authors.initials: BA
authors.lastname: Popescu
mesh_terms: D000368:Aged; D018619:Echocardiography, Doppler, Pulsed / Q000379:methods*; D005060:Europe; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016277:Ventricular Function, Left; D017725:Ventricular Pressure / Q000502:physiology*
keywords: Diastolic function; Left atrium; Left ventricular filling pressure; Speckle Tracking Echocardiography; Tissue Doppler