Noninvasive estimation of left ventricular end diastolic pressure from ejection fraction and mean arterial blood pressure

ABSTRACT

Non-invasive estimation of left ventricular end-diastolic pressure [LVEDP] has important clinical applications. Previous studies showed that LV systolic function is an important determinant of LV diastolic filling. However, non-invasive estimation of LVEDP using ejection fraction [EF] has not been tried. The aim of this study was to find out a reliable method for estimating LVEDP non-invasively by means of EF, including validation of the first data set. We tested the relationship LVEDP = mean arterial blood pressure [MABP] x [I-EF]. All measurements were taken using cardiac catheterization and left ventriculography, in 41 patients with coronary artery disease. Patients were divided into 2 groups according to the values of EF Group A [23 patients, ages 58 +/- 12 years] with EF> 0.75, and group B [18 patients, ages 59 +/- 10 years] with EF < 0.75. Estimated and measured LVEDP were tested using linear regression and correlation, the results were group A [r =0.758, P< 0.001], group B [r = 0.673, P < 0.01]. For 10 additional patients [validation group, ages 57 +/- 11 years] estimated LVEDP was calculated using formula from the first date set, estimated LVEDP = 0.54 [MABP x [I-EF]] 2.23. In the validation group, EF was measured using echocardiography within 24 hours of cardiac catheterization, and MABP was measured using sphygmomanometer just before cardiac catheterization. The estimated LVEDP showed a highly significant correlation with the invasively measured LVEDP [r =0.831, P<0.01] in addition, both had good agreement with each other [limits of agreement between -4 and 3 mmHg]. Thus, LVFDP can be estimated noninvasively from EFand MABP with an acceptable accuracy