Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy
Department of Cardiology, GIGA Cardiovascular Sciences, Heart Valve Clinic, University of Liège Hospital, Belgium.
Eur Heart J Cardiovasc Imaging. 2014 Jul;15(7):810-6. doi: 10.1093/ehjci/jeu022. Epub 2014 Mar 3.
The non-invasive estimation of left ventricular filling pressures (LVFPs) represents a main goal in the clinical setting. Current recommendations encourage the use of pulsed-wave Tissue Doppler for calculating the ratio between the preload-dependent transmitral E velocity and the average of septal and lateral early diastolic velocities (e') of the mitral annulus. Despite its wide use, real utility of the E/e' ratio has been recently challenged in patients with either very advanced heart failure or preserved left ventricular (LV) ejection fraction. However, only few studies performed the invasive and non-invasive estimation of LVFP simultaneously. The EURO-FILLING Study will validate the E/e' ratio (and additional non-invasive estimates) against simultaneously measured LVFP obtained by left heart catheterization in a multicentre study involving reference European echo laboratories collecting a wide population sample size of cardiac patients with and without heart failure.
The EURO-FILLING study is a large, prospective observational study in which simultaneous assessment of invasive and non-invasive measurements of LVFP will be acquired in eight reference European centres. Centralized reading of the collected parameters will be performed in a core laboratory. Not only standardized echo Doppler measurements but also novel echo parameters such as LV global longitudinal strain and global atrial strain (obtainable by two-dimensional speckle tracking echocardiography) will be tested for predicting invasive measurements of LVFP.
The EURO-FILLING study is expected to provide important information on non-invasive assessment of LVFP and to contribute to the standardization of this assessment in clinical practice.
无创估计左心室充盈压（LVFP）是临床中的主要目标。目前的建议鼓励使用脉冲波组织多普勒来计算依赖前负荷的二尖瓣 E 速度与二尖瓣环间隔和侧壁早期舒张速度（e'）的平均值之间的比值。尽管该比值的应用广泛，但最近在心力衰竭非常严重或左心室（LV）射血分数保留的患者中，该比值的实际效用受到了质疑。然而，只有少数研究同时进行了LVFP 的有创和无创评估。EURO-FILLING 研究将通过涉及参考欧洲超声心动图实验室的多中心研究，同时对来自心力衰竭和无心力衰竭的心脏患者的大样本量人群进行左心导管插入术测量的 LVFP 进行评估，以验证 E/e'比值（和其他非侵入性评估）。
EURO-FILLING 研究是一项大型前瞻性观察性研究，将在八个参考欧洲中心同时进行 LVFP 的有创和无创评估。将在核心实验室对收集的参数进行集中解读。不仅要测试标准化的超声多普勒测量，还要测试新型超声心动图参数，如 LV 整体纵向应变和整体心房应变（通过二维斑点追踪超声心动图获得），以预测 LVFP 的有创测量。
EURO-FILLING 研究有望提供有关 LVFP 无创评估的重要信息，并有助于在临床实践中对此评估进行标准化。
