![]() ![]() ![]() The positive predictive value of E/e’ ave was poor.Ĭorrelation between E/e’ and PCWP was first reported in 1997 by Nagueh SF et al. There was no difference in the mean PCWP between patients with E/e’ ave 14 groups. There was no significant linear correlation between E/e’ ave measured with the annulus and PCWP in patients with severe aortic stenosis. Our data does not support our hypothesis that there is a clinically relevant correlation between E/e’ ave and pulmonary capillary wedge pressure (PCWP) in patients with severe aortic stenosis. The correlation was not statistically significant between E/e’ med and PCWP (r=0.087, p=0.4474), and was also not significant between E/e’ lat and PCWP (r=0.116, p=0.3091). There was not enough sample size to calculate the negative predictive value of E/ e’ ave < 8 predicting PCWP < 15. Notably, only five patients had E/e’ ave 20 mmHg, 2 patients (40%) had a PCWP > 15 mmHg, 4 patients (80%) had a PCWP > 10 mmHg. The positive predictive value for E/e’ ave > 14 for detecting a PCWP > 15 was 40% for a PCWP > 20 mmHg was 15% and for a PCWP > 25 was 7.5%. The correlation did not improve when patients with depressed systolic ventricular function were studied independently from those with preserved ejection function (LVEF 14, 16 patients (40%) had a PCWP > 15 mmHg 6 patients (15%) had a PCWP > 20 mmHg and 3 patients (8%) had a PCWP > 25 mmHg. There was no significant correlation between E/e’ ave and PCWP (n=79, spearman, r=0.096 p=0.3994, spearman) ( Figure 2). 8– 14 We hypothesized that there is a clinically significant correlation between E/e’ and pulmonary capillary wedge pressure (PCWP) in patients with severe aortic stenosis. 1 However, recent reports suggest limited value of E/e’ as a surrogate for left atrial pressures in multiple disease states. 3– 7 The metric made its way into the guidelines and has remained a corner stone in the echocardiographic evaluation of diastology. 2 The metric quickly gained popularity in the literature in the late 1990s as a means to non-invasively evaluate left sided filling pressures in a number of clinical scenarios. 1 The use of E/e’ was originally proposed in the late 1990s as a means of correcting for the effect of ventricular relaxation on the value of E, thereby allowing for a better correlation with left atrial pressure. Accordingly, a number of echocardiographic methods suggested to estimate left heart filling pressures have been published in guideline documents. Both of these approaches are associated with procedural risks to the patient. The measurement of left ventricular filling pressure involves an invasive procedure including left and right heart catheterization for direct and indirect measurement. He helped in the design of the project and was the senior and corresponding author. Cobey, M.D., M.P.H., Mailing address: 800 Washington St, Boston, MA 02111, Institution: Tufts Medical Center, This author was the primary investigator for the project. Clair St, Suite 600, Chicago, IL 60611, Institution: Northwestern University, This author gave input in regarding the analytic approach to the data and helped with manuscript preparation.įrederick C. Thomas, M.D., Mailing address: 676 North St. Box 6100, Newport Beach, CA 92658, Institution: Hoag Hospital, This author gave input in the manuscript preparation. ![]() Pandian, MD, FACC, Mailing Address: One Hoag Drive, P.O. Weintraub, M.D., Mailing address: 800 Washington St, Boston, MA 02111, Institution: Tufts Medical Center, This author performed the procedures. Jamel Ortoleva, M.D., Mailing address: 800 Washington St, Boston, MA 02111, Institution: Tufts Medical Center, This author helped with the statistical analysis and manuscript preparation.Īndrew R. Luke's Hospital, This author assisted in collecting the data. Oklahoma St, Milwaukee, WI 53215, Institution: Advocate Aurora St. Ferrufino, MD, Mailing address: 800 Washington St, Boston, MA 02111, Institution: Tufts Medical Center, This author collected data and was involved in the manuscript preparation. Yoko Kagemoto, M.D., Mailing Address: 55 Fruit St, Boston, MA 02114, Institution: Massachusetts General Hospital, This author collected and analyzed the data and was the primary author involved in the manuscript preparation.Renan A. ![]()
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