![]() Patients in normal sinus rhythm (NSR), patients with chronic atrial fibrillation (AF) and patients with moderate-to-severe mitral valve regurgitation (MR), who were referred for clinically-indicated right-heart catheterization, were evaluated. The study group consisted of a training study and a testing study. A novel index based on the combination of LA function and volume evaluated by the time-LA volume curve using STE would be more accurate to evaluate PCWP than conventional parameters such as E/e′ and LAV. Therefore, the combined parameter of LA function and volume would be useful to estimate PCWP. LA function and volume are directly influenced by LV diastolic function. STE has also permitted the evaluation of phasic LA function and volume. Speckle tracking echocardiography (STE) has allowed the automatic construction of time-left atrial (LA) volume curves due to developments in echocardiographic technology. However, these parameters do not necessarily reflect the conditions of myocardial expansion during mid and late diastole. LV filling pressure and LV diastolic function can be estimated by the regional tissue velocity of the mitral annulus measured during early filling (e′) or the ratio of peak early transmitral flow velocity (E) to regional tissue velocity of the mitral annulus measured during early filling (E/e′). LA volume (LAV) has been thought to reflect elevated LV filling pressure and serves as a parameter to evaluate prognosis of cardiac disease. Therefore, the establishment of a noninvasive parameter to easily and accurately predict PCWP is important for the clinical diagnosis of HF. However, measurement of pulmonary capillary wedge pressure (PCWP) or LV filling pressure is an invasive method, and there have been few noninvasive indices that can precisely estimate PCWP or LV filling pressure. Evaluation of left atrial (LA) pressure is a useful parameter for the diagnosis and treatment of HF. The physiological cause in patients with HF with preserved ejection fraction (HFPEF) is a diastolic dysfunction. Regardless of the presence of abnormal left ventricular (LV) systolic fraction, chronic heart failure (HF) causes cardiac disease or cardiac death. ![]() The ePCWP measured by STE could be a useful parameter to improve clinical outcomes in patients with heart failure. ![]() The PCWP estimated by the KT index (ePCWP) had a strong correlation with PCWP obtained by right-heart catheterization (r = 0.92, p <0.001). We defined this index as the kinetics-tracking index (KT index). The following regression equation described the relationship between PCWP that was obtained by right-heart catheterization and active LAEF/minimum LAV index (volume was indexed to body surface area: LAVI) in the patients with sinus rhythm: PCWP = 10.8–12.4 (r = −0.86, p <0.001) (measurements from the apical 4-chamber view). Thus, we developed a novel index based on a combination of LAV and LA function that would estimate PCWP using STE. Owing to developments in echocardiographic technology, speckle tracking echocardiography (STE) has allowed automatic construction of time-left atrial (LA) volume (LAV) curves. The severity of left-sided heart failure can be evaluated by pulmonary capillary wedge pressure (PCWP) because PCWP reflects left ventricular (LV) filling pressure.
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