Which Diastolic Pressure Should Be Used to Assess Diastolic Function?
BACKGROUND: Although high left ventricular filling pressures [left ventricular (LV) end-diastolic pressure or pulmonary capillary wedge pressure (PCWP)] are widely taken as surrogates for LV diastolic dysfunction, the actual distending pressure that governs LV diastolic stretch is transmural pressure difference (∆PTM). Clinically, preferring ∆PTM over PCWP may improve diagnostic and therapeutic decision-making. We aimed to compare the clinical implications of diastolic function characterization based on PCWP or ∆PTM.
METHODS: We retrospectively screened our hospital database for adult patients with a clinical diagnosis of heart failure who underwent right heart catheterization. Echocardiographic diastolic dysfunction was graded according to the current guidelines. LV end-diastolic properties were assessed with construction of complete end-diastolic pressure-volume relationship (EDPVR) curves using the single-beat method. Survival status was checked via the electronic national health-care system.
RESULTS: A total of 693 cases were identified in our database; the final study population comprised 621 cases. ∆PTM-based, but not PCWP-based, EDPVR diastolic stiffness constants were significantly predictive of advanced diastolic dysfunction. PCWP-based diastolic stiffness constants were not able to predict 5-year mortality, whereas ∆PTM-based EDPVR stiffness constants and volumes all turned out to have significant predictive power for 5-year mortality.
CONCLUSION: Left ventricular diastolic function assessment can be improved using ∆PTM instead of PCWP. As ∆PTM ultimately linked to right-sided functions, this approach emphasizes the limitations of taking LV diastolic function as an isolated phenomenon and underlines the need for a complete hemodynamic assessment involving the right heart in therapeutic and prognostic decision-making processes.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
|---|---|
| Enthalten in: |
Anatolian journal of cardiology - (2024) vom: 29. Jan. |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Aslanger, Emre [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Revised 09.03.2024 published: Print-Electronic Citation Status Publisher |
|---|
| doi: |
10.14744/AnatolJCardiol.2024.3713 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM367749750 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM367749750 | ||
| 003 | DE-627 | ||
| 005 | 20240309232208.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240129s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.14744/AnatolJCardiol.2024.3713 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1321.xml |
| 035 | |a (DE-627)NLM367749750 | ||
| 035 | |a (NLM)38284565 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Aslanger, Emre |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Which Diastolic Pressure Should Be Used to Assess Diastolic Function? |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 09.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a BACKGROUND: Although high left ventricular filling pressures [left ventricular (LV) end-diastolic pressure or pulmonary capillary wedge pressure (PCWP)] are widely taken as surrogates for LV diastolic dysfunction, the actual distending pressure that governs LV diastolic stretch is transmural pressure difference (∆PTM). Clinically, preferring ∆PTM over PCWP may improve diagnostic and therapeutic decision-making. We aimed to compare the clinical implications of diastolic function characterization based on PCWP or ∆PTM | ||
| 520 | |a METHODS: We retrospectively screened our hospital database for adult patients with a clinical diagnosis of heart failure who underwent right heart catheterization. Echocardiographic diastolic dysfunction was graded according to the current guidelines. LV end-diastolic properties were assessed with construction of complete end-diastolic pressure-volume relationship (EDPVR) curves using the single-beat method. Survival status was checked via the electronic national health-care system | ||
| 520 | |a RESULTS: A total of 693 cases were identified in our database; the final study population comprised 621 cases. ∆PTM-based, but not PCWP-based, EDPVR diastolic stiffness constants were significantly predictive of advanced diastolic dysfunction. PCWP-based diastolic stiffness constants were not able to predict 5-year mortality, whereas ∆PTM-based EDPVR stiffness constants and volumes all turned out to have significant predictive power for 5-year mortality | ||
| 520 | |a CONCLUSION: Left ventricular diastolic function assessment can be improved using ∆PTM instead of PCWP. As ∆PTM ultimately linked to right-sided functions, this approach emphasizes the limitations of taking LV diastolic function as an isolated phenomenon and underlines the need for a complete hemodynamic assessment involving the right heart in therapeutic and prognostic decision-making processes | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Yıldırımtürk, Özlem |e verfasserin |4 aut | |
| 700 | 1 | |a Akaslan, Dursun |e verfasserin |4 aut | |
| 700 | 1 | |a Öz, Melih |e verfasserin |4 aut | |
| 700 | 1 | |a Güngör, Barış |e verfasserin |4 aut | |
| 700 | 1 | |a Ataş, Halil |e verfasserin |4 aut | |
| 700 | 1 | |a Mutlu, Bülent |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Anatolian journal of cardiology |d 2014 |g (2024) vom: 29. Jan. |w (DE-627)NLM239682068 |x 2149-2271 |7 nnns |
| 773 | 1 | 8 | |g year:2024 |g day:29 |g month:01 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.14744/AnatolJCardiol.2024.3713 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |j 2024 |b 29 |c 01 | ||