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Echocardiographic assessment of left ventricular diastolic pressure

McLean, Anthony S.

Current Opinion in Critical Care: June 2019 - Volume 25 - Issue 3 - p 252–258
doi: 10.1097/MCC.0000000000000601
CARDIOPULMONARY MONITORING: Edited by Anthony S. McLean
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Purpose of review Knowledge of the left ventricular pressures throughout the cardiac cycle is of considerable assistance in managing a haemodynamically unstable patient. Invasive pressure measurement is the only accurate way to analyze ventricular diastolic pressures but this is not feasible outside the catheterization laboratory, whereas the use of a pulmonary artery catheter or Doppler echocardiography, using surrogate measurements, is available at the bedside. The ever-increasing trend toward noninvasive monitoring puts echocardiography at the forefront and considerable effort has been made to define its role in this setting.

Recent findings Ongoing refinement of guidelines used to evaluate left ventricular diastolic function have provided a pathway for critical care physicians to better understand how to evaluate left ventricular end-diastolic pressure and/or left atrial pressures. A number of recent studies have investigated the accuracy of combined or single echocardiographic parameters in determining left ventricular diastolic pressures as compared to those obtained invasively. Specifically selected combined parameters have moderate accuracy.

Summary The recent literature on the clinical application of echocardiography on the accuracy in determining left ventricular noninvasively demonstrates that although far from perfect, it can be a very useful tool.

Department of Intensive Care Medicine, Nepean Hospital, The University of Sydney, Sydney, New South Wales, Australia

Correspondence to Anthony S. McLean, Department of Intensive Care Medicine, Nepean Hospital, The University of Sydney, Sydney, NSW 2749, Australia. E-mail: anthony.mclean@sydney.edu.au

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