The Use of Single-Beat TE-e' in Evaluation of Left Atrial Pressure in Critically Ill Patients: The TELAP-ICU Trial

Overview

This study evaluates a new single-beat echocardiographic technique (TE-e', the time difference between the onset of the mitral inflow E wave and the septal e' wave on tissue Doppler imaging) for estimating left atrial pressure (LAP) in critically ill patients, comparing it against the standard two-beat method. The goal is to determine whether the faster, single-beat method gives results as reliable as the conventional method, and whether it can help identify patients with elevated left atrial pressure without an invasive procedure.

Left atrial pressure (LAP) is an important measure in the care of critically ill patients but usually requires an invasive catheter to assess directly. Echocardiography offers a non-invasive alternative. One promising marker, TE-e' (the time difference between the onset of the mitral inflow E wave and the septal e' wave on tissue Doppler imaging), was recently incorporated into the 2025 American Society of Echocardiography (ASE) diastolic function guidelines. The conventional method for calculating TE-e' requires measurements from two separate heartbeats, introducing potential error from beat-to-beat heart rate variability - a common issue in the critically ill patients. This study assesses a novel single-beat method, in which both waveforms are captured on the same Doppler display within one cardiac cycle, eliminating that source of variability. Patients undergoing clinically indicated transthoracic echocardiography (TTE) in the Adult Intensive Care Unit of Queen Mary Hospital, Hong Kong will have TE-e' measured by both methods, along with other echocardiographic parameters associated with LAP, to evaluate correlation between the two methods and their relationship with clinically assessed LAP.

Conditions