Acute cardiac care & resuscitation
Comprehensive non-invasive haemodynamic assessment in acute decompensated heart failure-related cardiogenic shock: a step towards echodynamics
Authors' conclusion
Echocardiographic estimation of haemodynamics and subsequent phenotypization of CS is feasible with good agreement with invasive evaluation.
Study context
- Population
- ADHF-related cardiogenic shock (SCAI shock stage ≥B) undergoing right heart catheterization (RHC), 2020–2022
- Participants
- 101 participants
- Comparison
- Echocardiographic vs invasive haemodynamic assessment
- Outcome
- Correlation between echocardiographic and invasive assessment of haemodynamics (CI, WP, PAP, CPO, PAPi)
Methodological detailsconsecutive patients
- Consecutive patients
Performance
As reported in the abstract
Correlation of echocardiographic with invasive haemodynamics
CI, systolic pulmonary artery pressures (PAP), RAP and cardiac power output (CPO): good correlation (Pearson r)
r > 0.8
ePAPi: moderate correlation
r = 0.67
PVR: moderate correlation
r = 0.51
Further findings
Diagnostic accuracy of echocardiographic estimates vs invasive thresholds
- eCI for low output state (CI ≤2.2 L/min/m²): sensitivity / specificity
- 0.97 / 0.73
- eWP for elevated filling pressures (wedge pressure (WP) >15 mmHg): sensitivity / specificity
- 0.84 / 0.55
- ePAPs for PAPs ≥35 mmHg: sensitivity / specificity
- 0.87 / 0.63
- eCPO for CPO <0.6 W: sensitivity / specificity
- 0.76 / 0.85
- ePAPi for pulmonary artery pulsatility index (PAPi) <1.85: sensitivity / specificity
- 0.89 / 0.92
Agreement of echocardiographic cardiogenic shock (CS) phenotyping with invasive classification
- Good agreement, K value
- 0.457
- P value
- P < 0.001
Original publication
Comprehensive non-invasive haemodynamic assessment in acute decompensated heart failure-related cardiogenic shock: a step towards echodynamics. Eur Heart J Acute Cardiovasc Care. Published 16 July 2024. doi:10.
Summarised from the published abstract; every number is checked against it