Interv Akut Kardiol. 2009;8(3):128-133

Estimation of left ventricular filling pressure using echocardiography

prof. MUDr. Jaroslav Meluzín CSc

I. interní kardioangiologická klinika FN u sv. Anny v Brně

Left ventricular filling pressure (LVFP) is of utmost importance for the adequate diastolic filling of the left ventricle (LV). The determination

of LVFP allows to diagnose primary diastolic heart failure, to assess prognosis of patients with congestive heart failure, and to predict the

risk of acute heart failure decompensation. Echocardiography is the most frequently utilized noninvasive method in determining LVFP.

Pulsed Doppler echocardiography allows to measure the peak velocity of LV filling in early diastole (E), Doppler tissue echocardiography

enables to quantify the peak velocity of early diastolic annular motion (Ea). The E/Ea ratio has been found to significantly correlate with

LVFP and it is commonly clinically used to predict noninvasively LVFP. E/Ea > 15 is associated with the increase in LVFP, while E/Ea < 8

is associated with normal LVFP values. However, there are clinical situations (acute heart failure decompensation, severe mitral regurgitation,

the presence of biventricular pacing or hypertrophic cardiomyopathy), in which the prediction of LVFP using E/Ea ratio fails.

At present, new methods and parameters are tested to improve the accuracy of echocardiography in predicting LVFP. In conclusion,

echocardiography represents a relaible method of detecting the increase in LVFP in the majority of clinical situations. However, parameters

utilized thus far are not sufficiently precise to determine LVFP in an individual patient and, at present, are not able to fully replace

invasive methods in determining LVFP.

Keywords: left ventricular filling pressure, echocardiography, diastolic function.

Published: July 15, 2009  Show citation