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. Echocardiography. 2008 Oct;25(9):946-54. PMID: 18771556
In a small study of 56 patients, including 19 with a LVEDP > 15 mm Hg (22 ± 4) by left heart catheterization, no patients had rales, 42% had radiographic pulmonary vascular redistribution, and only 11% had BNP > 100 pg/dL.
These results report even less sensitivity for the chest radiograph than we found in our earlier meta-analysis (http://pubmed.gov/894569). These results are also worse than the original large study of the BNP that found a cutoff of > 50 pg/dL gives high sensitivity (http://pubmed.gov/12124404).
It is unclear what led these patients to their catheterization, but the low sensitivities suggest these patients may have had asymptomatic, chronically elevated LVEDP.
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