J Cardiovasc Ultrasound.  2006 Mar;14(1):12-18.

A Comparison of Tissue Doppler Echocardiography and B-Type Natriuretic Peptide in Estimating Pulmonary Capillary Wedge Pressure

• Bae WH
• Lee HG
• Oh JH
• Lee DW
• Ahn BJ
• Kim SH
• Lee JS
• Kim MY
• Kim YS
• Lee HC
• Kim J
• Kim JH
• Chun KJ
• Hong TJ
• Shin YW

Abstract

BACKGROUND: There are several echocardiographic parameters, such as early transmitral velocity/tissue Doppler mitral annular early diastolic velocity(E/Ea) or deceleration time, reported to be reliable indices to estimate pulmonary capillary wedge pressure(PCWP). Recently, B-type natriuretic peptide(BNP) level is also reported to increase in accordance with increased left ventricular filling pressure in systolic or diastolic heart failure. This study was performed to compare E/Ea and BNP for the ability to estimate PCWP.
METHODS
Several echocardiographic Doppler parameters including especially E/Ea were obtained from transthoracic Doppler echocardiography. Simultaneously, serum BNP level and PCWP estimated by using Swan-Ganz catheter were obtained, respectively.
RESULTS
E/Ea revealed a correlation of r=0.88 (p<0.001) with PCWP compared with r=0.45 (p<0.001) between BNP and PCWP. E/Ea > or =11 was the optimal cutoff to predict PCWP > or =15 mmHg (sensitivity, 94%; specificity, 90%), whereas the optimal BNP cutoff was > or =250 pg/mL (sensitivity, 52%; specificity, 74%).
CONCLUSION
Mitral E/Ea has a better correlation with PCWP than BNP. Mitral E/Ea appears more sensitive and specific than BNP for PCWP > or =15 mmHg in cardiac patients.

Keyword

E/Ea; B-type natriuretic peptide; Pulmonary capillary wedge pressure; Echocardiography

MeSH Terms

Capillaries
Catheters
Deceleration
Echocardiography
Echocardiography, Doppler*
Heart Failure, Diastolic
Humans
Natriuretic Peptide, Brain*
Pulmonary Wedge Pressure*
Sensitivity and Specificity
Natriuretic Peptide, Brain