Daniele Orso, Marta Sabbadin, Giacomo Bacchetti, Gabriele Simeoni, Tiziana Bove
{"title":"组织多普勒成像方法(E/e')与左心室充盈压侵入性测量之间的相关性:系统回顾、元分析和元回归。","authors":"Daniele Orso, Marta Sabbadin, Giacomo Bacchetti, Gabriele Simeoni, Tiziana Bove","doi":"10.1053/j.jvca.2024.08.014","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Evaluation of pulmonary capillary wedge pressure (PCWP) through right heart catheterization can indirectly provide an estimation of the filling pressure of the left ventricle. Echocardiography can estimate left ventricular compliance using mitral annular tissue Doppler imaging (TDI). The E/e' ratio refers to the correlation between the peak mitral inflow (E-wave) velocity and early diastolic tissue Doppler mitral annular velocity (e'). The main purpose of this systematic review was to establish the correlation between echocardiographic E/e' ratio and PCWP. The correlation between E/e' and left ventricular end-diastolic pressure (LVEDP) was evaluated as a secondary objective.</p><p><strong>Design: </strong>A systematic review and meta-analysis of observational studies was conducted. The search was based on Medline (PubMed), Scopus, and Web of Science.</p><p><strong>Setting: </strong>Intensive care unit or cardiac intensive care unit.</p><p><strong>Participants: </strong>Adult patients.</p><p><strong>Interventions: </strong>Any study comparing the left ventricular filling pressure obtained by cardiac catheterization (reference) and echocardiographic evaluation, in particular TDI analysis (intervention), were included.</p><p><strong>Measurements and main results: </strong>The pooled analysis included 94 studies from the initially identified 7,304 records. The correlation was 0.48 (95% CI 0.42-0.54, Q = 420.52, I<sup>2</sup> = 84.8%) for PCWP and 0.50 (95% CI 0.38-0.60, Q = 210.91, I<sup>2</sup> = 89.1%) for LVEDP.</p><p><strong>Conclusions: </strong>The E/e' ratio moderately correlated with PCWP/LVEDP. The correlation was stable irrespective of the sites where e' was measured, but each site has its own limitations for specific patient subpopulations. The correlation was weak in patients with heart failure with a preserved ejection fraction.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Correlation Between Tissue Doppler Imaging Method (E/e') and Invasive Measurements of Left Ventricular Filling Pressures: A Systematic Review, Meta-Analysis, and Meta-Regression.\",\"authors\":\"Daniele Orso, Marta Sabbadin, Giacomo Bacchetti, Gabriele Simeoni, Tiziana Bove\",\"doi\":\"10.1053/j.jvca.2024.08.014\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Evaluation of pulmonary capillary wedge pressure (PCWP) through right heart catheterization can indirectly provide an estimation of the filling pressure of the left ventricle. Echocardiography can estimate left ventricular compliance using mitral annular tissue Doppler imaging (TDI). The E/e' ratio refers to the correlation between the peak mitral inflow (E-wave) velocity and early diastolic tissue Doppler mitral annular velocity (e'). The main purpose of this systematic review was to establish the correlation between echocardiographic E/e' ratio and PCWP. The correlation between E/e' and left ventricular end-diastolic pressure (LVEDP) was evaluated as a secondary objective.</p><p><strong>Design: </strong>A systematic review and meta-analysis of observational studies was conducted. The search was based on Medline (PubMed), Scopus, and Web of Science.</p><p><strong>Setting: </strong>Intensive care unit or cardiac intensive care unit.</p><p><strong>Participants: </strong>Adult patients.</p><p><strong>Interventions: </strong>Any study comparing the left ventricular filling pressure obtained by cardiac catheterization (reference) and echocardiographic evaluation, in particular TDI analysis (intervention), were included.</p><p><strong>Measurements and main results: </strong>The pooled analysis included 94 studies from the initially identified 7,304 records. The correlation was 0.48 (95% CI 0.42-0.54, Q = 420.52, I<sup>2</sup> = 84.8%) for PCWP and 0.50 (95% CI 0.38-0.60, Q = 210.91, I<sup>2</sup> = 89.1%) for LVEDP.</p><p><strong>Conclusions: </strong>The E/e' ratio moderately correlated with PCWP/LVEDP. The correlation was stable irrespective of the sites where e' was measured, but each site has its own limitations for specific patient subpopulations. The correlation was weak in patients with heart failure with a preserved ejection fraction.</p>\",\"PeriodicalId\":15176,\"journal\":{\"name\":\"Journal of cardiothoracic and vascular anesthesia\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2024-08-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of cardiothoracic and vascular anesthesia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1053/j.jvca.2024.08.014\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of cardiothoracic and vascular anesthesia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1053/j.jvca.2024.08.014","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:通过右心导管检查评估肺毛细血管楔压(PCWP)可间接估算左心室充盈压。超声心动图可通过二尖瓣环组织多普勒成像(TDI)估测左心室顺应性。E/e'比值指的是二尖瓣流入峰值(E 波)速度与舒张早期组织多普勒二尖瓣瓣环速度(e')之间的相关性。本系统综述的主要目的是确定超声心动图 E/e' 比值与 PCWP 之间的相关性。E/e'与左心室舒张末压(LVEDP)之间的相关性作为次要目标进行评估:设计:对观察性研究进行了系统回顾和荟萃分析。检索基于 Medline (PubMed)、Scopus 和 Web of Science:重症监护病房或心脏重症监护病房:干预措施任何比较心导管检查(参考)和超声心动图评估(特别是 TDI 分析)获得的左心室充盈压(干预)的研究均包括在内:汇总分析从最初确定的 7,304 份记录中纳入了 94 项研究。PCWP 的相关性为 0.48(95% CI 0.42-0.54,Q = 420.52,I2 = 84.8%),LVEDP 的相关性为 0.50(95% CI 0.38-0.60,Q = 210.91,I2 = 89.1%):结论:E/e'比值与 PCWP/LVEDP 呈中度相关。结论:E/e'比值与 PCWP/LVEDP 呈中度相关,无论在哪个部位测量 e',相关性都很稳定,但每个部位对于特定的患者亚群都有其自身的局限性。射血分数保留的心衰患者的相关性较弱。
Correlation Between Tissue Doppler Imaging Method (E/e') and Invasive Measurements of Left Ventricular Filling Pressures: A Systematic Review, Meta-Analysis, and Meta-Regression.
Objectives: Evaluation of pulmonary capillary wedge pressure (PCWP) through right heart catheterization can indirectly provide an estimation of the filling pressure of the left ventricle. Echocardiography can estimate left ventricular compliance using mitral annular tissue Doppler imaging (TDI). The E/e' ratio refers to the correlation between the peak mitral inflow (E-wave) velocity and early diastolic tissue Doppler mitral annular velocity (e'). The main purpose of this systematic review was to establish the correlation between echocardiographic E/e' ratio and PCWP. The correlation between E/e' and left ventricular end-diastolic pressure (LVEDP) was evaluated as a secondary objective.
Design: A systematic review and meta-analysis of observational studies was conducted. The search was based on Medline (PubMed), Scopus, and Web of Science.
Setting: Intensive care unit or cardiac intensive care unit.
Participants: Adult patients.
Interventions: Any study comparing the left ventricular filling pressure obtained by cardiac catheterization (reference) and echocardiographic evaluation, in particular TDI analysis (intervention), were included.
Measurements and main results: The pooled analysis included 94 studies from the initially identified 7,304 records. The correlation was 0.48 (95% CI 0.42-0.54, Q = 420.52, I2 = 84.8%) for PCWP and 0.50 (95% CI 0.38-0.60, Q = 210.91, I2 = 89.1%) for LVEDP.
Conclusions: The E/e' ratio moderately correlated with PCWP/LVEDP. The correlation was stable irrespective of the sites where e' was measured, but each site has its own limitations for specific patient subpopulations. The correlation was weak in patients with heart failure with a preserved ejection fraction.
期刊介绍:
The Journal of Cardiothoracic and Vascular Anesthesia is primarily aimed at anesthesiologists who deal with patients undergoing cardiac, thoracic or vascular surgical procedures. JCVA features a multidisciplinary approach, with contributions from cardiac, vascular and thoracic surgeons, cardiologists, and other related specialists. Emphasis is placed on rapid publication of clinically relevant material.