Value of conventional and tissue Doppler echocardiography in the estimation of left ventricular filling pressure

Background: Various conventional and tissue Doppler parameters have been proposed for the estimation of left ventricular filling pressure. Aim: To assess the utility of several conventional and tissue Doppler parameters in the estimation of left ventricular end diastolic pressure (LVEDP). Method: Among 40 consecutive patients LVEDP was correlated with pulsed Doppler of mitral inflow and pulsed tissue Doppler of lateral mitral annulus. Results: Among all studied Doppler variables, E′/A′ ratio showed the most significant correlation with LVEDP (r = 0.612, p < 0.001). Among patients with grade II and III diastolic dysfunction, E′/A′ ratio showed the best correlation with LVEDP (r = 0.81, p < 0.001) with the following regression equation: LVEDP = 1.77 + (20.4 × E′/A′) while in patients with grade I diastolic dysfunction no correlation exists (r = 0.11, p = 0.63). Weak significant correlation was detected between E/E′ ratio and LVEDP (r = 0.382, p = 0.016). An E/E′ ratio > 12 had 25% sensitivity and 100% specificity to identify patients with elevated LVEDP (>15 mm Hg) with a positive predictive value of 100%. On the other hand, an E/E′ ratio of