PMID- 37949842
OWN - NLM
STAT- MEDLINE
DCOM- 20240328
LR  - 20240329
IS  - 2047-2412 (Electronic)
IS  - 2047-2404 (Print)
IS  - 2047-2404 (Linking)
VI  - 25
IP  - 4
DP  - 2024 Mar 27
TI  - Echocardiographic estimation of pulmonary artery wedge pressure: invasive 
      derivation, validation, and prognostic association beyond diastolic dysfunction 
      grading.
PG  - 498-509
LID - 10.1093/ehjci/jead301 [doi]
AB  - AIMS: Grading of diastolic function can be useful, but indeterminate 
      classifications are common. We aimed to invasively derive and validate a 
      quantitative echocardiographic estimation of pulmonary artery wedge pressure 
      (PAWP) and to compare its prognostic performance to diastolic dysfunction 
      grading. METHODS AND RESULTS: Echocardiographic measures were used to derive an 
      estimated PAWP (ePAWP) using multivariable linear regression in patients 
      undergoing right heart catheterization (RHC). Prognostic associations were 
      analysed in the National Echocardiography Database of Australia (NEDA). In 
      patients who had undergone both RHC and echocardiography within 2 h (n = 90), 
      ePAWP was derived using left atrial volume index, mitral peak early velocity (E), 
      and pulmonary vein systolic velocity (S). In a separate external validation 
      cohort (n = 53, simultaneous echocardiography and RHC), ePAWP showed good 
      agreement with invasive PAWP (mean +/- standard deviation difference 0.5 +/- 
      5.0 mmHg) and good diagnostic accuracy for estimating PAWP >15 mmHg [area under 
      the curve (95% confidence interval) 0.94 (0.88-1.00)]. Among patients in NEDA [n 
      = 38,856, median (interquartile range) follow-up 4.8 (2.3-8.0) years, 2756 
      cardiovascular deaths], ePAWP was associated with cardiovascular death even after 
      adjustment for age, sex, and diastolic dysfunction grading [hazard ratio (HR) 
      1.08 (1.07-1.09) per mmHg] and provided incremental prognostic information to 
      diastolic dysfunction grading (improved C-statistic from 0.65 to 0.68, P < 
      0.001). Increased ePAWP was associated with worse prognosis across all grades of 
      diastolic function [HR normal, 1.07 (1.06-1.09); indeterminate, 1.08 (1.07-1.09); 
      abnormal, 1.08 (1.07-1.09), P < 0.001 for all]. CONCLUSION: Echocardiographic 
      ePAWP is an easily acquired continuous variable with good accuracy that 
      associates with prognosis beyond diastolic dysfunction grading.
CI  - (c) The Author(s) 2023. Published by Oxford University Press on behalf of the 
      European Society of Cardiology.
FAU - Lindow, Thomas
AU  - Lindow T
AUID- ORCID: 0000-0002-2943-0034
AD  - Clinical Physiology, Clinical Sciences, Lund University, Lund, Sweden.
AD  - Department of Clinical Physiology, Vaxjo Central Hospital, Vaxjo, Sweden.
AD  - Department of Research and Development, Region Kronoberg, Vaxjo, Sweden.
AD  - Kolling Institute, Royal North Shore Hospital, University of Sydney, Kolling 
      Building, St Leonards, Sydney, New South Wales 2065, Australia.
FAU - Manouras, Aristomenis
AU  - Manouras A
AUID- ORCID: 0000-0002-6617-2070
AD  - Department of Cardiology, Karolinska University Hospital, Karolinska Institutet, 
      Stockholm, Sweden.
FAU - Lindqvist, Per
AU  - Lindqvist P
AUID- ORCID: 0000-0002-8192-9166
AD  - Department of Clinical Physiology, Surgical and Perioperative sciences, Umea 
      University, Umea, Sweden.
FAU - Manna, Daniel
AU  - Manna D
AD  - Department of Clinical Physiology, Vaxjo Central Hospital, Vaxjo, Sweden.
AD  - Department of Research and Development, Region Kronoberg, Vaxjo, Sweden.
FAU - Wieslander, Bjorn
AU  - Wieslander B
AUID- ORCID: 0000-0002-5606-0008
AD  - Department of Clinical Physiology, Vaxjo Central Hospital, Vaxjo, Sweden.
AD  - Department of Clinical Physiology, Karolinska University Hospital, Karolinska 
      Institutet, Stockholm 17176, Sweden.
FAU - Kozor, Rebecca
AU  - Kozor R
AUID- ORCID: 0000-0002-6437-5018
AD  - Kolling Institute, Royal North Shore Hospital, University of Sydney, Kolling 
      Building, St Leonards, Sydney, New South Wales 2065, Australia.
FAU - Strange, Geoff
AU  - Strange G
AUID- ORCID: 0000-0001-6800-7119
AD  - Institute for Health Research, School of Medicine, University of Notre Dame, 
      Fremantle, Australia.
AD  - Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
AD  - Heart Research Institute, Sydney, Australia.
AD  - Royal Prince Alfred Hospital, Sydney, Australia.
FAU - Playford, David
AU  - Playford D
AUID- ORCID: 0000-0003-4492-1103
AD  - Institute for Health Research, School of Medicine, University of Notre Dame, 
      Fremantle, Australia.
FAU - Ugander, Martin
AU  - Ugander M
AUID- ORCID: 0000-0003-3665-2038
AD  - Kolling Institute, Royal North Shore Hospital, University of Sydney, Kolling 
      Building, St Leonards, Sydney, New South Wales 2065, Australia.
AD  - Department of Clinical Physiology, Karolinska University Hospital, Karolinska 
      Institutet, Stockholm 17176, Sweden.
LA  - eng
GR  - New South Wales Health/
GR  - Heart Research Australia/
GR  - University of Sydney/
GR  - Region Kronoberg/
GR  - 20160787/The Swedish Heart and Lung Foundation/
GR  - 2019-01338/Swedish Research Council/
GR  - Actelion Pharmaceuticals/
GR  - Bayer Pharmaceuticals/
GR  - #1055214/GlaxoSmithKline/
GR  - National Health and Medical Research Council/
GR  - NEDA Ltd/
GR  - Pfizer/
PT  - Journal Article
PL  - England
TA  - Eur Heart J Cardiovasc Imaging
JT  - European heart journal. Cardiovascular Imaging
JID - 101573788
SB  - IM
MH  - Humans
MH  - Pulmonary Wedge Pressure
MH  - Prognosis
MH  - *Echocardiography, Doppler/methods
MH  - *Echocardiography
MH  - Cardiac Catheterization/methods
MH  - Pulmonary Artery
PMC - PMC10966330
OTO - NOTNLM
OT  - diastolic dysfunction
OT  - echocardiography
OT  - heart failure
OT  - pulmonary capillary wedge pressure
COIS- Conflict of interest: None declared.
EDAT- 2023/11/11 11:42
MHDA- 2024/03/28 06:46
PMCR- 2023/11/09
CRDT- 2023/11/10 23:03
PHST- 2023/09/13 00:00 [received]
PHST- 2023/11/01 00:00 [revised]
PHST- 2023/11/04 00:00 [accepted]
PHST- 2024/03/28 06:46 [medline]
PHST- 2023/11/11 11:42 [pubmed]
PHST- 2023/11/10 23:03 [entrez]
PHST- 2023/11/09 00:00 [pmc-release]
AID - 7394853 [pii]
AID - jead301 [pii]
AID - 10.1093/ehjci/jead301 [doi]
PST - ppublish
SO  - Eur Heart J Cardiovasc Imaging. 2024 Mar 27;25(4):498-509. doi: 
      10.1093/ehjci/jead301.