The following is a summary of “Echocardiographic assessment of pulmonary capillary wedge pressure by E/e’ ratio: A systematic review and meta-analysis,” published in the March 2023 issue of the Critical Care by Martelli, et al.
There is an ongoing discussion on the accuracy of echocardiographic methods for measuring pulmonary capillary wedge pressure (PCWP). The E/e’ ratio has been considered a valid technique since it was first described. This research aimed to assess the proof supporting E/e’s usefulness in estimating PCWP and its diagnostic accuracy for high PCWP. Researchers searched MEDLINE and Embase from their origin to July of 2022 for studies that compared E/e’ to PCWP.
Only articles published after 2010 were included in the analysis. Studies that looked back in time or focused on a population that was yet to be adults were disregarded. There were 28 studies included, with a total of 1,964 participants. There was only a slight association between E/e’ and PCWP in the combined data from the studies. The correlation coefficient (r) is 0.43 (95% CI: 0.37-0.48) on average when weighted.
Neither the lowered nor the preserved ejection fraction groups differed significantly. E/e’ has been studied for its potential as a diagnostic tool for high PCWP in 13 separate investigations. For PCWP greater than 15 mmHg, the area under the receiver operating characteristic curve (AUC) was calculated to be between 0.60 and 0.91. It seems that E/e’ has a moderate relationship with PCWP and a respectable accuracy for high PCWP.
Source: https://www.sciencedirect.com/science/article/abs/pii/S0883944123000308
