Evaluate the Sensitivity and Specificity Echocardiography in Trans-Doppler and Tissue Doppler Method in the Estimation of Left Ventricular End-Diastolic Pressure
BACKGROUND
Non-invasive survey of left ventricular end-diastolic pressure (LVEDP) by transmitral Doppler echocardiography and tissue Doppler imaging carries important information about left ventricular diastolic function in chosen subsets of patients. This study is planned to assess whether mitral annular velocities (lateral annulus) as assessed by tissue Doppler imaging and transmitral Doppler echocardiography are associated with invasive measures of left ventricular end diastolic pressure and also the estimation of sensitivity and specificity of these methods.


METHODS
One hundred ten consecutive patients admitted to cardiac catheterization underwent simultaneous Doppler interrogation measurements of left ventricular pressure were obtained with fluid-filled pressure. The E/Ea ratio associated well with LVEDP (P<0.005 r=0.4) and the correlation more marked in the patients with reduced contractile function. This correlation was independent of gender.


RESULTS
The E/Ea ration of <8 best discriminated elevated (LVEDP>12) from normal LVEDP with a sensitivity of 73.5% and specificity 57.8%, PPV and NPV were 75.75% and 55% respectively. Our study results also showed that quantitative estimation of LVEDP could be suggested by the equation of LVEDP=1.2 E/Ea+6.67 ± 8 mmHg P<0.005 B=0.4. Male-LVEDP=0.9 E/Ea + 7.78 ± 7.67 mmHg (r=0.4 Pa<0.005) EF ≥ 50 % -+LVEDP=1.48 E/Ea + 9.05 ± 5.23 (r=0.4 P<0.05) EF<50% -+LVEDP=0.76 E/Ea + 8.4 ± 2.3 (r=0.5 P<0.005)