Noninvasive Prediction of Pulmonary Capillary Wedge Pressure in Patients With Normal Left Ventricular Ejection Fraction: Comparison of Cardiac Magnetic Resonance With Comprehensive Echocardiography.

Authors

• Wissam Rahi
• Imad Hussain
• Miguel A Quinones
• William A Zoghbi
• Dipan J Shah
• Sherif F Nagueh

Publication/Presentation Date

5-1-2024

Abstract

BACKGROUND: Cardiac magnetic resonance (CMR) was recently reported to predict mean pulmonary capillary wedge pressure (PCWP). However, there is a paucity of data on its accuracy for estimation of PCWP in patients with normal left ventricular (LV) ejection fraction (EF). We sought to examine its accuracy against the invasive gold standard and to compare it with the accuracy of comprehensive echocardiography.

METHODS: Stable patients with EF of ≥50% who underwent right heart catheterization, CMR, and echocardiographic imaging within 1 week were included. Pulmonary capillary wedge pressure was estimated by CMR using a previously validated equation where PCWP is estimated based on the left atrial maximum volume and LV mass. Echocardiographic estimation of PCWP was based on 2016 American Society of Echocardiography/European Association of Cardiovascular Imaging guidelines, taking into account the presence of myocardial disease.

RESULTS: The mean age of the 79 patients was 55 ± 15 years, and 58.2% were female. There were 33 patients with PCWP >15 mm Hg by right heart catheterization. Cardiac magnetic resonance prediction of PCWP had an area under the curve (AUC) = 0.72. In comparison, echocardiographic prediction of PCWP showed a higher accuracy (AUC = 0.87 vs AUC = 0.72; P = .008).

CONCLUSIONS: In patients with normal LV EF, CMR estimation of mean PCWP based on LV mass and left atrial volume has modest accuracy for detecting patients with mean PCWP >15 mm Hg. Comprehensive echocardiography predicts elevated PCWP with higher accuracy in comparison with CMR.

Volume

37

Issue

5

First Page

486

Last Page

494

ISSN

1097-6795

Published In/Presented At

Rahi, W., Hussain, I., Quinones, M. A., Zoghbi, W. A., Shah, D. J., & Nagueh, S. F. (2024). Noninvasive Prediction of Pulmonary Capillary Wedge Pressure in Patients With Normal Left Ventricular Ejection Fraction: Comparison of Cardiac Magnetic Resonance With Comprehensive Echocardiography. Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, 37(5), 486–494. https://doi.org/10.1016/j.echo.2024.02.001

Disciplines

Medicine and Health Sciences

PubMedID

38354759

Department(s)

Fellows and Residents

Document Type

Article