Andersen et al reported an algorithm for evaluating the left ventricular filling pressure based on echocardiography. The authors are from Oslo University Hospital, McMaster University, Methodist DeBakey Heart and Vascular Center, Massachusetts General Hospital, Cleveland Clinic and Yonsei University.
Method: echocardiography
Outcome: normal or elevated left atrial pressure (LAP), as measure of left ventricular filling pressure
Parameters:
(1) peak tricuspid regurgitation velocity in m/sec
(2) left atrial maximal volume index in mL per square meter
(3) E and A from mitral flow velocity in cm/sec
(4) e' from mitral annular velocity in cm/sec
E/e' =
= (E) / (e')
E/A =
= (E) / (A)
Parameter
Finding
Points
E/e'
<= 14
0
> 14
1
peak tricuspid regurgitation velocity
<= 2.8
0
> 2.8
1
left atrial maximal volume index
<= 34
0
> 34
1
score =
= SUM(points for all of the parameters)
E/A Ratio
E
Points
<= 0.8
<= 50
normal LAP
<= 0.8
> 50
Column B below
0.81 to 1.99
NA
Column C below
>= 2
NA
elevated LAP
Score
Column B
Column C
2 or 3
normal LAP
elevated LAP
0 or 1
cannot determine LAP
cannot determine LAP
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