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Diastolic pressure–volume quotient (DPVQ) as a novel echocardiographic index for estimation of LV stiffness in HFpEF

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Abstract

Background

End-diastolic pressure–volume relationship and LV stiffness, key parameter for diagnosing diastolic dysfunction within Heart failure with preserved ejection fraction (HFpEF) patients, can be directly obtained only by invasive pressure–volume (PV) measurements. Therefore, we aimed to establish diastolic pressure–volume quotient (DPVQ), as a new non-invasive parameter for estimation of LV stiffness in HFpEF obtained by 3D echocardiography (3DE) and tissue Doppler imaging.

Methods

Twenty-three HFpEF patients with suspected diastolic dysfunction, scheduled for invasive pressure–volume loop analyses obtained by conductance catheterization were included. PV loop measurements were compared with simultaneous 3DE full-volume recordings of the LV and tissue Doppler measurements for LV diastolic function. LV filling index E/E′ was used for estimation of diastolic pressure. Single-beat method was performed to calculate LV stiffness constant (β SB).

Results

Fourteen of twenty-three patients showed increased and 9/23 revealed normal LV stiffness β. End-diastolic, end-systolic and stroke volume obtained by 3DE correlated with those from PV loop analysis (r = 0.63, r = 0.57 and r = 0.71, respectively). Estimated diastolic pressure and DPVQ correlated with invasive measurements (r = 0.81 and r = 0.91, both p < 0.001). Accordingly, calculated stiffness constant β SB revealed a significant correlation with invasive determined stiffness coefficient β (r = 0.73, p < 0.001). DPVQ and β SB correlated with NT-proBNP plasma level (r = 0.67 and r = 0.58, both, p < 0.001).

Conclusion

3D echocardiography allows accurate non-invasive measurements of diastolic pressure–volume quotient which correlates with invasive determined LV stiffness in HFpEF.

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Acknowledgments

This study was granted by the European Association of Echocardiography/European society of Cardiology to MK and by the EC, FP7-Health-2010, MEDIA (261409) to CT.

Conflict of interest

None declared.

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Authors and Affiliations

  1. Department of Cardiology, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany

    Mario Kasner & David Sinning

  2. Division of Cardiology, Columbia University, New York, USA

    Daniel Burkhoff

  3. Department of Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany

    Carsten Tschöpe

  4. Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany

    Carsten Tschöpe

  5. German Centre for Cardiovascular Research (DZHK), Hamburg, Germany

    Carsten Tschöpe

Authors
  1. Mario Kasner
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  2. David Sinning
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  4. Carsten Tschöpe
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Correspondence to Mario Kasner.

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Kasner, M., Sinning, D., Burkhoff, D. et al. Diastolic pressure–volume quotient (DPVQ) as a novel echocardiographic index for estimation of LV stiffness in HFpEF. Clin Res Cardiol 104, 955–963 (2015). https://doi.org/10.1007/s00392-015-0863-y

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  • DOI: https://doi.org/10.1007/s00392-015-0863-y

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