Reliability of the latest echographic recommendations for estimating left ventricular filling pressures: A comparative study with left cardiac catheterization

Introduction The current recommendations regarding the estimation of left ventricular filling pressures are based on expert consensus. We tried to evaluate the reliability of the actual algorithm in comparison with the left cardiac catheterization and with the algorithms published in 2009. Method We enrolled 100 adult patients scheduled for coronary angiography between December 2017 and May 2018. An estimation of filling pressures by transthoracic echocardiography and cardiac catheterization on the same day was performed. Results The mean age of our patients was 62.79 years ± 10.35 with a male predominance (sex ratio at 3.34). The majority had coronary artery disease (66%). The mean ejection fraction was 53% ± 13. The 2016 algorithm was superior to those published in 2009 compared to the invasive estimate. In fact, its sensitivity and specificity were 70.14% and 86.66% with an accuracy of 75.25% versus 62.21%, 86.66% and 69.79% respectively for the 2009 algorithms. Analysis, in case of preserved systolic function, showed a great decrease in the results of the 2009 algorithms while the 2016 algorithm remained valid. Regarding echographic parameters, the E/e’ ratio had the highest coefficient value ( r  = 0.47) whereas no correlation was found for the tricuspid regurgitation jet velocity. Conclusion In addition to its simplicity, the actual decision tree for estimating left ventricular filling pressures seems reliable and more efficient than the previous ones.