Heart failure & cardiomyopathies
New Algorithm for Estimating Left Ventricular Filling Pressure by Echocardiography
Authors' conclusion
The new algorithm increases the feasibility of estimating LVFP and has good accuracy with incremental value when natriuretic peptides are considered.
Study context
- Population
- Patients referred for cardiac catheterization; LV filling pressure (LVFP) >15 mm Hg considered elevated949 analysed
- Participants
- 951 patients
- Comparison
- New echocardiographic algorithm vs 2016 guidelines for estimating left ventricular (LV) filling pressure
- Outcome
- Indeterminate LVFP and accuracy for elevated LVFP
Methodological detailsmulticentre, observational
- Multicentre
- Observational
Performance
As reported in the abstract
| Test or model | Value | Indeterminate LVFP | Sensitivity | Specificity | Accuracy |
|---|---|---|---|---|---|
| New algorithm | 2 events | 2 patients | 86% | 86% | 86% |
| 2016 guidelines | 38 events | 38 |
Value
New algorithm2 events
2016 guidelines38 events
Indeterminate LVFP
New algorithm2 patients
2016 guidelines38
Sensitivity
New algorithm86%
2016 guidelines— not stated in the abstract
Specificity
New algorithm86%
2016 guidelines— not stated in the abstract
Accuracy
New algorithm86%
2016 guidelines— not stated in the abstract
- New algorithm vs 2016 guidelines: P < 0.0001 — indeterminate LVFP
- New algorithm vs 2016 guidelines: P < 0.0001 — accuracy, all patients
Further findings
| Outcome | P value |
|---|---|
| Accuracy, by EF (subgroup)EF ≥50%: higher accuracy | P < 0.0001 |
Accuracy, by EF (subgroup)
- Accuracy similar in patients with EF <50%
Incremental value of echocardiography over natriuretic peptides
- Net reclassification improvement
- 1.1 (P<0.0001)
- Integrated discrimination improvement
- 0.3 (P<0.0001)
- 663 patients with natriuretic peptides data
Original publication
New Algorithm for Estimating Left Ventricular Filling Pressure by Echocardiography. Circulation. Published 27 June 2025. doi:10.
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