Simple Two-Dimensional Echocardiographic Scoring System for the Estimation of Left Ventricular Filling Pressure

Murayama, Michito; Iwano, Hiroyuki; Nishino, Hisao et al.

Journal of the American Society of Echocardiography, 2021, 34(7), 723-734

Permalink : https://hdl.handle.net/2115/82530

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https://doi.org/10.1016/j.echo.2021.02.013     13

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アクセス権
open access
URI
https://hdl.handle.net/2115/82530
タイトル
Simple Two-Dimensional Echocardiographic Scoring System for the Estimation of Left Ventricular Filling Pressure
著者
Murayama, Michito ; Iwano, Hiroyuki ; Nishino, Hisao ; Tsujinaga, Shingo ; Nakabachi, Masahiro ; Yokoyama, Shinobu ; Aiba, Miho ; Okada, Kazunori ; Kaga, Sanae ; Sarashina, Miwa ; Chiba, Yasuyuki ; Ishizaka, Suguru ; Motoi, Ko ; Nishida, Mutsumi ; Shibuya, Hitoshi ; Kamiya, Kiwamu ; Nagai, Toshiyuki ; Anzai, Toshihisa
著者名
Murayama, Michito
著者名
Iwano, Hiroyuki
著者名
Nishino, Hisao
著者名
Tsujinaga, Shingo
著者名
Nakabachi, Masahiro
著者名
Yokoyama, Shinobu
著者名
Aiba, Miho
著者名
Okada, Kazunori
著者名
Kaga, Sanae
著者名
Sarashina, Miwa
著者名
Chiba, Yasuyuki
著者名
Ishizaka, Suguru
著者名
Motoi, Ko
著者名
Nishida, Mutsumi
著者名
Shibuya, Hitoshi
著者名
Kamiya, Kiwamu
著者名
Nagai, Toshiyuki
e-Rad_Researcher
60232089
著者名
Anzai, Toshihisa
言語
英語
キーワード
Echocardiography
Pathophysiology
Heart failure
Left ventricular filling pressure
Predictive ability
発行日
2021-07
出版者
Elsevier
収録物名
Journal of the American Society of Echocardiography
巻(号)
34(7)
ページ
723-734
抄録
Background: When left ventricular filling pressure (LVFP) increases, the mitral valve opens early and precedes tricuspid valve opening in early diastole. The authors hypothesized that a visually assessed time sequence of atrioventricular valve opening could become a new marker of elevated LVFP. The aim of this study was to test the diagnostic ability of a novel echocardiographic scoring system, the visually assessed time difference between mitral valve and tricuspid valve opening (VMT) score, in patients with heart failure. Methods: One hundred nineteen consecutive patients who underwent cardiac catheterization within 24 hours of echocardiographic examination were retrospectively analyzed as a derivation cohort. In addition, a prospective study was conducted to validate the diagnostic ability of the VMT score in 50 patients. Elevated LVFP was defined as mean pulmonary artery wedge pressure (PAWP) >_ 15 mm Hg. The time sequence of atrioventricular valve opening was visually assessed and scored (0 = tricuspid valve first, 1 = simultaneous, 2 = mitral valve first). When the inferior vena cava was dilated, 1 point was added, and VMT score was ultimately graded as 0 to 3. Cardiac events were recorded for 1 year after echocardiography. Results: In the derivation cohort, PAWP was elevated with higher VMT scores (score 0,10 +/- 5; score 1,12 +/- 4; score 2, 22 +/- 8; score 3, 28 +/- 4 mm Hg; P < .001, analysis of variance). VMT score >_ 2 predicted elevated PAWP with accuracy of 86% and showed incremental predictive value over clinical variables and guideline recommended diastolic function grading. These observations were confirmed in the prospective validation cohort. Importantly, VMT score >_ 2 discriminated elevated PAWP with accuracy of 82% in 33 patients with monophasic left ventricular inflow in the derivation cohort. Kaplan-Meier analysis demonstrated that patients with VMT scores >_ 2 were at higher risk for cardiac events than those with VMT scores # 1 (P < .001). Conclusions: VMT scoring could be a novel additive marker of elevated LVFP and might also be associated with adverse outcomes in patients with heart failure.
資源タイプ
学術雑誌論文
出版タイプ
Version of Record
PISSN
0894-7317
関連情報 (isIdenticalTo)
出版社版DOI
https://doi.org/10.1016/j.echo.2021.02.013