Diagnostic accuracy of Doppler echocardiography for determining left ventricular diastolic pressure elevation: Prospective comparison to chest radiography, serum B-type natriuretic peptide, and chest auscultation

Background: Doppler echocardiography (DE), chest radiography (CXR), serum B-type natriuretic peptide (BNP) measurement and physical examination are all commonly employed to estimate left ventricular diastolic pressure (LVDP) in clinical care. There are no published studies directly comparing the diagnostic accuracy of these tests. Methods and Results: DE, BNP, CXR, and physical examination were performed on 56 consecutive patients immediately following clinically indicated cardiac catheterization with measurement of LVDP. LVDP measured preceding atrial contraction at end-expiration was elevated (>16 mmHg) in 19 subjects. Diagnostic accuracies were 79%, 70%, 61% for DE, BNP, and CXR, respectively. None of the study subjects had evidence of raised LVDP by chest auscultation. Conclusions: The diagnostic accuracy of DE compares favorably to other noninvasive markers for prediction of invasively determined LVDP.