Estimation of left ventricular end diastolic pressure (lvedp) in patients with ischemic heart disease by echocardiography and compare it with the results of cardiac catheterization

Abstract

<strong>BACKGROUND:</strong> Doppler echocardiography has been proposed as an appropriate non-invasive<br />assay to estimate left ventricular end diastolic pressure (LVEDP). The aim of present research<br />was to estimate the LVEDP in patients with ischemic heart disease by echocardiography and<br />compare it with the results of cardiac catheterisation and to determine the effect of different<br />echocardiographic variables on its measurement.<br /><strong>METHODS:</strong> In this descriptive-analytic study, patients with diagnosed ischemic heart disease<br />were selected by nonrandomized sampling method. Selected population underwent M-mode<br />and pulse doppler echocardiographic evaluation and parameters such as Q-Mitral valve E<br />(Q-MVE), Q-Aortic valve closure (Q-AVC), Aortic valve closure-E (AVC-E), Q-Mitral valve<br />closure/Aortic valve closure-E (Q-MVC/AVC-E), left ventricle-deceleration time (LV-DT), peak<br />velocity-deceleration time (PV-DT) and A/E velocity time integral (A/E VTI) were evaluated.<br />Immediately after echocardiography all patients underwent left heart catheterization for LVEDP<br />measurement. The relation between different echocardiographic measurements and LVEDP,<br />obtained by cardiac catheterization, was evaluated.<br /><strong>RESULTS:</strong> In this study, 47 patients with ischemic heart disease with mean age (&plusmn;SD) of<br />53 &plusmn; 13 were studied. There was a significant correlation between LVDEP and A/E VTI (r=0.44,<br />P = 0.001, and also between LVEDP and PV-DT in patients with A/E VTI &ge;1.1(r = -0.58, P = 0.02).<br />There was a significant correlation between LVEDP and Q-MVC/AVC-E in patients with LVEDP<br />&gt;18mmHg (r = 0.76, P= 0.03) and those with LVEDP &le;18 mmHg and A/E VTI &lt; 1.1<br />(r = 0.37, P= 0.03). The correlation between LVEDP and A/E VTI was more significant in men,<br />in patients aged &gt; 50 years with EF &gt; 55%, without LVH, without MR and those with coronary<br />artery disease (P &lt; 0.05).<br /><strong>CONCLUSION:</strong> Some echocardiographic indices such as A/E VTI, Q-MVC/AVC-E and PV-DT<br />are able to measure LVEDP especially in male patients aged &gt; 50 years, without LVH, without<br />MR and those with coronary artery disease but it is necessary to determine specific conditions<br />and factors affecting these indices, by further studies.<br /><strong>Keywords:</strong> LVEDP, Coronary Artery Disease, Echocardiography