scholarly journals Left Ventricular Filling Pressures in Heart Failure With Preserved Ejection Fraction

2017 ◽  
Vol 5 (11) ◽  
pp. 802-804 ◽  
Author(s):  
Masaru Obokata ◽  
Barry A. Borlaug
2018 ◽  
Vol 15 (3) ◽  
pp. 7-16
Author(s):  
M. Ababei ◽  
A. Câmpeanu ◽  
D. Nistorescu ◽  
O. Zaharia ◽  
P Portelli ◽  
...  

AbstractBackground. CA-125 is a tumor antigen expressed on the surface of ovarian cells, used to monitor the treatment of ovarian cancer (normal upper limit is 35U/mL), but it seems also to have a role as biomarker in heart failure (HF).Aim. To determine CA-125 changes in acute-decompensated HF (ADHF) patients.Method. The study group included 110 patients (mean age 72±10 years, 63% men) with ADHF caused by ischemic cardiomyopathy. The subjects were clinically, ecocardiographically and biologically (NT-proBNP, PCR, serum uric acid (sUA), CA-125) evaluated.Results. CA-125 at admission was 53±33 U/mL and decreased at discharge to 34±17 U/mL, without any difference between males and females. The mean level of CA-125 was significantly higher in patients with pleural effusion.There was a significant difference between NT-proBNP at admission in obese versus normoponderal patients, which was maintained at discharge. In the same time, the CA-125 did not show significant differences between obese and normoponderal subjects at admission and discharge. The mean level of CA-125 was significantly higher for subjects with reduced ejection fraction and with elevated left ventricular filling pressures versus subjects with preserved ejection fraction and normal left ventricular filling pressures.The CA-125 correlated with LVEF (R=-0.221, p=0.02), with NT-proBNP (R=0.371, p<0.001), with the inflammation marker - PCR (R=0.284, p=0.003) and oxidative stress marker - sUA (R=0.234, p=0.015).Conclusions. The wide availability of CA-125, its relatively low cost, its correlation with known prognostic markers in HF and the additional information provided make it a valuable biomarker that can be used in monitoring ADHF patients.


2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
J Motiejunaite ◽  
P Jourdain ◽  
B Gellen ◽  
M T Bailly ◽  
A A Bouchachi ◽  
...  

Abstract Context Echocardiography is an essential tool for evaluation of left ventricular filling pressure (LVFP). We aimed to assess the usefulness of inferior vena cava (IVC) measurement and the 2016 ESC recommendations in patients with suspected heart failure with preserved ejection fraction (HFpEF). Methods Invasive hemodynamics and echocardiographic measurements were documented in 132 consecutive patients referred to our centre with dyspnea, left ventricular ejection fraction (LVEF) ≥50%, and suspected pulmonary hypertension on a previous echocardiogram. Echocardiographic measurements of mitral flow (E and A wave velocities), the E/e’ratio, indexed left atrial volume (LAV), tricuspid regurgitation velocity (TRV) and the IVC size and collapsibility were obtained. Increased LVFP was defined by an invasive pulmonary artery wedge pressure (PAWP) &gt; 15 mmHg. Results In sinus rhythm patients, the sum of the criteria (E/e’ ratio &gt; 14, TRV &gt; 2.8 m/s and indexed LAV &gt; 34 ml/m²) ≥ 2 had a positive predictive value (PPV) of 63% for PAWP &gt; 15 mmHg, whereas a dilated (&gt; 2.1 cm) and/or non collapsible (≤ 50%) IVC had a PPV of 83%. In atrial fibrillation (AF), a dilated and/or non collapsible IVC had an 86% PPV for increased LVFP. We found that 16% of patients with elevated LVFP were more accurately classified using IVC evaluation than using the current guidelines criteria (net reclassification improvement = 0.25, p &lt;0.05). Conclusion Echographic measurements of the IVC size and collapsibility outperformed the classic 2016 recommendations algorithm to evaluate LVFP in sinus rhythm patients with suspected HFpEF. The IVC study was also valuable in patients with atrial fibrillation.


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