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BackgroundʊDoppler echocardiography is currently applied for the assessment of left ventricular (LV) and right ventricular (RV) hemodynamics in patients with cardiovascular disease. However, there are conflicting reports about its accuracy in patients with unstable decompensated heart failure. The objective of this study was to evaluate the accuracy of the technique in patients with unstable heart failure. Methods and ResultsʊConsecutive patients with decompensated heart failure had simultaneous assessment of LV and RV hemodynamics invasively and by Doppler echocardiography. In 79 patients, the non-invasive measurements of stroke volume (r=0.83, p<0.001), pulmonary artery systolic (r=0.83, p<0.001) and diastolic pressure (r=0.51, p=0.009), and mean right atrial pressure (r=0.85, p<0.001) all had significant correlations with invasively acquired measurements. Several Doppler indices had good accuracy in identifying patients with pulmonary capillary wedge pressure>15 mmHg (AUC from 0.86 to 0.92). The recent ASE/EAE guidelines were highly accurate (sensitivity: 98%, specificity: 91%) in identifying patients with increased wedge pressure. In 12 repeat studies, Doppler echocardiography readily detected the changes in mean wedge pressure (r=0.75, p=0.005) as well as changes in pulmonary artery systolic pressure and mean right atrial pressure. ConclusionsʊDoppler echocardiography provides reliable assessment of LV hemodynamics in patients with decompensated heart failure. Key Words: diastole; doppler; echocardiography; heart failure by guest on September 17