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Invasive Validation of the Left Ventricular Global Longitudinal Strain for Estimating LV Filling Pressure
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  • Turkan Tan,
  • irem Muge Akbulut,
  • Ayse Demirtola,
  • Nazli Turan Serifler,
  • Nil Ozyuncu,
  • Kutay Vurgun,
  • Kerim Esenboga,
  • Haci Kurklu,
  • Volkan Kozluca,
  • Demet Gerede,
  • Aydan Ongun Ozdemir,
  • Eralp Tutar,
  • Irem Dincer
Turkan Tan
Ankara University Department of Cardiology
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irem Muge Akbulut
Ankara University Faculty of Medicine
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Ayse Demirtola
Ankara University Department of Cardiology
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Nazli Turan Serifler
Ankara University Department of Cardiology
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Nil Ozyuncu
Ankara University Department of Cardiology
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Kutay Vurgun
Ankara University Department of Cardiology
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Kerim Esenboga
Ankara University Faculty of Medicine
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Haci Kurklu
Lokman Hekim Universitesi
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Volkan Kozluca
Ankara University
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Demet Gerede
Ankara University
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Aydan Ongun Ozdemir
Ankara University School of Medicine
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Eralp Tutar
Ankara University Department of Cardiology
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Irem Dincer
Ankara University School of Medicine
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Abstract

Purpose: An elevated left ventricular (LV) filling pressure is the main finding in patients with heart failure with preserved ejection fraction, which is estimated with an algorithm using echocardiographic parameters recommended by the recent American Society of Echocardiography (ASE)/European Association of Cardiovascular Imaging (EACVI) guideline. In this study, we sought to determine the efficacy of LV global longitudinal strain (GLS) to estimate the elevated LV filling pressure. Methods and Results: 73 prospectively selected patients undergoing left ventricular catheterization (mean age 63.19±9.64, 68.5% male) participated in this study. Using the algorithm, the LV filling pressure was estimated with the echo parameters obtained within 24hrs before the catheterization. The LV GLS was measured using the automated functional imaging system (GE, Vivid E9 USA). Invasive LV pre-A pressure corresponding to mean left atrial pressure (LAP) was used as a reference, and >12 mm Hg was defined as elevated. The invasive LV filling pressure was elevated in 43 (58.9%) and normal in 30 patients (41.1%). In 9 (12.3%) patients of 73 are defined as indeterminate based on the 2016 algorithm. Using the ROC method, -18.1% of LV GLS estimated the LV filling pressure (AUC=0.79, 73% specificity, 84% sensitivity) with higher sensitivity compared with the algorithm (AUC=0.76, 77% specificity, 72% sensitivity). Conclusions: We confirmed that the LV GLS is feasible and reproducible in estimating LV filling pressure. In addition, LV GLS highly predicts elevated LAP as E/e’ and TR jet velocity and may be used as major criteria for the diagnosis of HFpEF

Peer review status:ACCEPTED

02 Jan 2021Submitted to Echocardiography
02 Jan 2021Submission Checks Completed
02 Jan 2021Assigned to Editor
20 Jan 2021Reviewer(s) Assigned
19 Feb 2021Review(s) Completed, Editorial Evaluation Pending
22 Feb 2021Editorial Decision: Revise Major
20 Mar 20211st Revision Received
22 Mar 2021Assigned to Editor
22 Mar 2021Submission Checks Completed
22 Mar 2021Reviewer(s) Assigned
27 Mar 2021Review(s) Completed, Editorial Evaluation Pending
12 Apr 2021Editorial Decision: Revise Major
20 Apr 20212nd Revision Received
21 Apr 2021Submission Checks Completed
21 Apr 2021Assigned to Editor
22 Apr 2021Reviewer(s) Assigned
15 May 2021Review(s) Completed, Editorial Evaluation Pending
20 May 2021Editorial Decision: Accept