• Je něco špatně v tomto záznamu ?

Improvement in the prediction of exercise-induced elevation of left ventricular filling pressure in patients with normal left ventricular ejection fraction

J. Meluzin, Z. Starek, T. Kulik, J. Jez, F. Lehar, J. Tomandl, L. Dusek, J. Wolf, P. Leinveber, M. Novak,

. 2017 ; 34 (1) : 78-86. [pub] 20161025

Jazyk angličtina Země Spojené státy americké

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc17031358

BACKGROUND: Noninvasive diagnosis of exercise-induced elevation of left ventricular filling pressure is difficult and remains unsatisfactory. The aim of this study was to assess the accuracy of the ratio of early diastolic transmitral (E) to mitral annular (e') velocity and to determine new parameters or parameter combinations with the ability to predict exercise-induced left atrial pressure (LAP) elevation. METHODS AND RESULTS: Eighty patients with paroxysmal atrial fibrillation (AF) referred for catheter AF ablation underwent simultaneous exercise echocardiography and direct invasive LAP measurements, as well as a resting and postexercise biomarker analysis. Exercise E/e' ≥8.85 predicted exercise LAP ≥20 mm Hg with 61.5% sensitivity and 88.9% specificity (area under the curve [AUC], 0.76). Of all of the individual parameters tested, the best prediction was achieved with exercise E/s' (s'=peak systolic mitral annular velocity) ≥8.75 (sensitivity, 88.5%; specificity, 64.8%; positive predictive value, 54.8%; negative predictive value, 92.1%; AUC, 0.84). However, the combination of exercise E/A (A = late diastolic transmitral flow velocity) ≥1.22 + exercise E/e' ≥8.85 + exercise s'≤11.05 cm/s provided the most precise prediction of exercise LAP elevation (sensitivity, 84.6%; specificity, 79.6%; positive predictive value, 66.7%; negative predictive value, 91.5%; AUC, 0.90). CONCLUSIONS: Exercise E/e', when used as a sole parameter, was not sufficiently reliable to predict exercise-induced elevation of LAP. The application of a multivariate-adjusted combination of parameters appeared to be the preferable approach for the noninvasive prediction of exercise LAP elevation.

Citace poskytuje Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc17031358
003      
CZ-PrNML
005      
20171102104521.0
007      
ta
008      
171025s2017 xxu f 000 0|eng||
009      
AR
024    7_
$a 10.1111/echo.13403 $2 doi
035    __
$a (PubMed)27779336
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a xxu
100    1_
$a Meluzin, Jaroslav $u Department of Cardiovascular Diseases, ICRC, St. Anne's University Hospital, Brno, Czech Republic. Department of Cardiovascular Diseases, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
245    10
$a Improvement in the prediction of exercise-induced elevation of left ventricular filling pressure in patients with normal left ventricular ejection fraction / $c J. Meluzin, Z. Starek, T. Kulik, J. Jez, F. Lehar, J. Tomandl, L. Dusek, J. Wolf, P. Leinveber, M. Novak,
520    9_
$a BACKGROUND: Noninvasive diagnosis of exercise-induced elevation of left ventricular filling pressure is difficult and remains unsatisfactory. The aim of this study was to assess the accuracy of the ratio of early diastolic transmitral (E) to mitral annular (e') velocity and to determine new parameters or parameter combinations with the ability to predict exercise-induced left atrial pressure (LAP) elevation. METHODS AND RESULTS: Eighty patients with paroxysmal atrial fibrillation (AF) referred for catheter AF ablation underwent simultaneous exercise echocardiography and direct invasive LAP measurements, as well as a resting and postexercise biomarker analysis. Exercise E/e' ≥8.85 predicted exercise LAP ≥20 mm Hg with 61.5% sensitivity and 88.9% specificity (area under the curve [AUC], 0.76). Of all of the individual parameters tested, the best prediction was achieved with exercise E/s' (s'=peak systolic mitral annular velocity) ≥8.75 (sensitivity, 88.5%; specificity, 64.8%; positive predictive value, 54.8%; negative predictive value, 92.1%; AUC, 0.84). However, the combination of exercise E/A (A = late diastolic transmitral flow velocity) ≥1.22 + exercise E/e' ≥8.85 + exercise s'≤11.05 cm/s provided the most precise prediction of exercise LAP elevation (sensitivity, 84.6%; specificity, 79.6%; positive predictive value, 66.7%; negative predictive value, 91.5%; AUC, 0.90). CONCLUSIONS: Exercise E/e', when used as a sole parameter, was not sufficiently reliable to predict exercise-induced elevation of LAP. The application of a multivariate-adjusted combination of parameters appeared to be the preferable approach for the noninvasive prediction of exercise LAP elevation.
650    _2
$a fibrilace síní $x diagnóza $x patofyziologie $7 D001281
650    _2
$a rychlost toku krve $7 D001783
650    _2
$a diastola $7 D003971
650    _2
$a echokardiografie $x metody $7 D004452
650    _2
$a cvičení $x fyziologie $7 D015444
650    _2
$a ženské pohlaví $7 D005260
650    _2
$a lidé $7 D006801
650    _2
$a mužské pohlaví $7 D008297
650    _2
$a lidé středního věku $7 D008875
650    _2
$a mitrální chlopeň $x diagnostické zobrazování $x patofyziologie $7 D008943
650    _2
$a prediktivní hodnota testů $7 D011237
650    _2
$a reprodukovatelnost výsledků $7 D015203
650    _2
$a tepový objem $x fyziologie $7 D013318
650    _2
$a systola $7 D013599
650    _2
$a funkce levé komory srdeční $x fyziologie $7 D016277
650    _2
$a komorový tlak (srdce) $x fyziologie $7 D017725
655    _2
$a časopisecké články $7 D016428
700    1_
$a Starek, Zdenek $u Department of Cardiovascular Diseases, ICRC, St. Anne's University Hospital, Brno, Czech Republic. Department of Cardiovascular Diseases, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
700    1_
$a Kulik, Tomas $u Department of Cardiovascular Diseases, ICRC, St. Anne's University Hospital, Brno, Czech Republic. Department of Cardiovascular Diseases, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
700    1_
$a Jez, Jiri $u Department of Cardiovascular Diseases, ICRC, St. Anne's University Hospital, Brno, Czech Republic. Department of Cardiovascular Diseases, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
700    1_
$a Lehar, Frantisek $u Department of Cardiovascular Diseases, ICRC, St. Anne's University Hospital, Brno, Czech Republic. Department of Cardiovascular Diseases, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
700    1_
$a Tomandl, Josef $u Department of Biochemistry, ICRC, Brno, Czech Republic. Department of Biochemistry, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
700    1_
$a Dusek, Ladislav $u Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
700    1_
$a Wolf, Jiri $u Department of Cardiovascular Diseases, ICRC, St. Anne's University Hospital, Brno, Czech Republic. Department of Cardiovascular Diseases, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
700    1_
$a Leinveber, Pavel $u Department of Cardiovascular Diseases, ICRC, St. Anne's University Hospital, Brno, Czech Republic.
700    1_
$a Novak, Miroslav $u Department of Cardiovascular Diseases, ICRC, St. Anne's University Hospital, Brno, Czech Republic. Department of Cardiovascular Diseases, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
773    0_
$w MED00001491 $t Echocardiography (Mount Kisco, N.Y.) $x 1540-8175 $g Roč. 34, č. 1 (2017), s. 78-86
856    41
$u https://pubmed.ncbi.nlm.nih.gov/27779336 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y a $z 0
990    __
$a 20171025 $b ABA008
991    __
$a 20171102104614 $b ABA008
999    __
$a ok $b bmc $g 1254951 $s 992385
BAS    __
$a 3
BAS    __
$a PreBMC
BMC    __
$a 2017 $b 34 $c 1 $d 78-86 $e 20161025 $i 1540-8175 $m Echocardiography $n Echocardiography $x MED00001491
LZP    __
$a Pubmed-20171025

Najít záznam

Citační ukazatele

Možnosti archivace