Abstract 11321: Non-Invasive Assessment of Left Ventricular End-Diastolic Pressure Using A Novel Global Strain Imaging Diastolic Index
Background: The determination of left ventricular end-diastolic pressure (LVEDP) is important in the management of patients with heart failure. Recently, strain imaging diastolic index (SI-DI) has been proposed to assess regional abnormal relaxation induced by myocardial ischemia. We aimed to examine whether non-invasive global SI-DI obtained using 2D speckle tracking imaging (2DSI) could predict elevated levels of LVEDP.
Methods: We performed conventional echocardiography and 2DSI in 31 patients (23 males and 8 females, age 63±16) with various causes of cardiovascular disease. All patients underwent catheterization and LV pressure curve was obtained to assess LVEDP in catheterization procedure. SI-DI was defined as LV longitudinal changes during the first one-third of diastolic duration (Figure 1). In 2DSI, SI-DI of 18 LV segments in the apical 4-, 3-, 2-cahmber views were measured. Global SI-DI was calculated as averaged SI-DI in 18 LV segment. Mitral inflow and tissue Doppler imaging were also assessed.
Results: Mean LVEDP derived from catheterization was 25.08±7.73 mmHg. In linear regression analyses, global SI-DI had a significant linear correlation with LVEDP, Y=0.723-0.011X (r=0.873, p<0.001) (Figure 2). In multiple stepwise regression analysis, global SI-DI was the strongest independent determinant of LVEDP (β=-0.872, p<0.001), among E velocity, E/A ratio, e' and E/e'.
Conclusions: Global SI-DI derived from 2DSI can be used to estimate LVEDP noninvasively. Global SI-DI may provide more accurate estimation of LV filling pressure, compared with conventional mitral inflow and tissue speckle tracking.
- © 2011 by American Heart Association, Inc.