tailieunhanh - Evaluation of left ventricular filling pressure using doppler echocardiography in severe heart failure patients with reduced ejection fraction

To estimate left ventricular filling pressure using Doppler echocardiography according to American Society of Echocardiography guidelines in NYHA classes III - IV heart failure patients with an ejection fraction ≤ 40%. | Journal of military pharmaco-medicine n08-2018 EVALUATION OF LEFT VENTRICULAR FILLING PRESSURE USING DOPPLER ECHOCARDIOGRAPHY IN SEVERE HEART FAILURE PATIENTS WITH REDUCED EJECTION FRACTION Le Thi Bich Van1; Pham Nguyen Vinh2 SUMMARY Objectives: To estimate left ventricular filling pressure using Doppler echocardiography according to American Society of Echocardiography guidelines in NYHA classes III - IV heart failure patients with an ejection fraction ≤ 40%. Subjects and methods: A descriptive crosssectional study on 101 patients with NYHA class III - IV severe chronic heart failure with an ejection fraction ≤ 40%, from April 2016 to June 2018 at Hochiminh City Heart Institute. Left ventricular filling pressure was estimated using 5 Doppler echocardiographic parameters, including peak E-wave velocity, mean E/A ratio, mean E/e’ ratio, mean peak tricuspid regurgitation velocity and mean left atrial volume index. Results: We have identified 83 patients () with elevated left ventricular filling pressure and 18 patients with normal left ventricular filling pressure (). Peak E-wave velocity = ± cm/s; mean E/A ratio = ± ; mean E/e’ ratio = ± ; peak tricuspid regurgitation velocity > m/s () and mean 2 (left atrial) volume index > 34 mL/m (96%). We recognized that an E-wave deceleration time ≤ 125 ms, which accounted for over 50% () of patients in the ejection fraction ≤ 30% and was statistically higher than 30% of patients having ejection fraction ≤ 40% () (p = ). Only of patients had mean E/e’ ratio > 14, while of patients were shown to have elevated left ventricular filling pressure after integrating 5 echocardiographic parameters. Diastolic dysfunction grade I, II and III group each accounted for , and of patients, respectively. As for the left ventricular filling pressure group, more than half of them () had diastolic dysfunction grade III. Conclusion: By integrating these