Correlation between Doppler echocardiography and right heart catheterization assessment of systolic pulmonary artery pressure in patients with severe aortic stenosis

2020 ◽  
Vol 37 (3) ◽  
pp. 380-387 ◽  
Author(s):  
Jury Schewel ◽  
Michael Schlüter ◽  
Tobias Schmidt ◽  
Karl‐Heinz Kuck ◽  
Christian Frerker ◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Doppler Echocardiography ◽  
Severe Aortic Stenosis ◽  
Right Heart Catheterization ◽  
Heart Catheterization ◽  
Systolic Pulmonary Artery Pressure ◽  
Right Heart ◽  
Artery Pressure

scholarly journals P1529 Impact of the new PH guidelines on echocardiographic definition leading to double demand of right heart catheterization

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
C Fauvel ◽  
O Raitiere ◽  
J Burdeau ◽  
N Si Belkacem ◽  
F Bauer
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Tricuspid Regurgitation ◽  
Peak Velocity ◽  
Right Heart Catheterization ◽  
Heart Catheterization ◽  
Right Heart ◽  
Artery Pressure ◽  
Mean Pulmonary Artery Pressure ◽  
Definition Of

Abstract Background Doppler echocardiography is the most widespread and well-recognized technique for the screening of patients with pulmonary hypertension (PH). When tricuspid regurgitation peak velocity (TRPV) ≥3.4 m/s, right heart catheterization is requested to confirm mean pulmonary artery pressure >25 mm Hg. In the proceedings from the 6th world symposium on pulmonary arterial hypertension recently released, the new definition of PH has been lowered to mean pulmonary artery pressure > 20 mm Hg. Purpose The purpose of our work was twofold : i) to determine a new cut-off value for TRPV to accommodate the new hemodynamic definition of PH, ii) to investigate the impact on the demand of right heart catheterization (RHC) from our echo CORE lab. Methods We extracted and analyzed both the haemodynamic and echocardiographic records of 130 patients who underwent investigations the same day. Tricuspid regurgitation peak velocity was measured in apical-4 chamber view using continuous-wave doppler modality and compared to mean pulmonary artery pressure recorded from fluid-filled catheter. Results Tricuspid regurgitation peak velocity has a weak correlation with mean pulmonary pressure (y = 9.2x-2.2, r² = 0.22, p < 0.01). Targeting a mean pulmonary pressure on right heart catheterization of 20 mm Hg for the definition of PH, receiver operating characteristic curve analysis demonstrated a good association between TRPV and PH diagnosis (area under the curve, 0.78 ; p < 0.001). The cut-off value obtained for TRPV was 3.0 m/s (Se = 0.78, Sp = 0.37). From 01/01/18 to 31/12/18, 2539 out of 6215 had TRPV recorded from which 283 had TRPV ≥ 3.0 m/s (24,1%) and 615 had TRPV ≥ 3.4 m/s (11,1%). When applied to a community population the new TRPV cutoff > 3m/s used as surrogate for mean pulmonary artery pressure > 20 mm Hg may produce a 111% increase of right heart catheterization demand. Conclusions The new definition of pulmonary hypertension (invasive mean pulmonary artery pressure > 20mm Hg) necessitates revisiting tricuspid regurgitation peak velocity > 3 m/s as a screening test leading to more than twice RHC demand.

P4685Validation of noninvasive pulmonary artery pressure/flow relationship: echocardiography vs right heart catheterization

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Caravita ◽  
P Yerly ◽  
C Baratto ◽  
C Dewachter ◽  
A Rimouche ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Doppler Echocardiography ◽  
Pulmonary Circulation ◽  
Right Heart Catheterization ◽  
Peak Exercise ◽  
Heart Catheterization ◽  
Right Heart ◽  
Pressure Flow ◽  
Relationship Of

Abstract Background Invasive pressure-flow (P/Q) relationship of the pulmonary circulation can detect the presence of pulmonary hypertension (PH) during exercise and provide information on patients' symptoms and assess disease severity. Doppler-echocardiography was reported to provide accurate but imprecise noninvasive estimates of both resting and exercise pulmonary haemodynamics. However, data on the direct comparison of invasive vs noninvasive approaches to build pressure-flow relationship are scarce. Purpose To compare echocardiographic estimates with invasive measurements of P/Q relationship of the pulmonary circulation during exercise. Methods Patients undergoing a clinically indicated right heart catheterization and echocardiography were studied at rest and during exercise. The ratio between mean pulmonary artery pressure and cardiac output at peak exercise (TPR), as well as P/Q slope throughout exercise were calculated. Both TPR and P/Q slope are abnormal when ≥3 mmHg/L/min. Echocardiographic estimates were compared with invasive measurements. Results Sixty patients were included (mean age 65±14 years, 73% female). PH was present at rest in 38 cases (63%), of precapillary origin in 23 (61%). Heart failure with preserved ejection fraction was diagnosed in 23 patients, of which 17 had no PH at rest. TPR at peak exercise and P/Q slope were abnormal (≥3 mmHg/L/min) in the majority of patients (56 and 45 subjects, respectively). Echocardiographic estimates of P/Q slope and TPR correlated significantly although weakly with invasive measurements (R2=0.38 and 0.56, respectively, p<0.001). Bias of echocardiography for P/Q slope and TPR was 1.1±4.2 and 0.4±2.9 mmHg/L/min, respectively (figure). Sensitivity of echocardiography to detect an abnormal TPR or P/Q slope (i.e. ≥3 mmHg/L/min) was 100 and 98%, respectively, faced by low specificity (0 and 33%, respectively). Figure 1 Conclusions Doppler-echocardiography can provide rather accurate and sensitive but imprecise estimates of pressure-flow relationships of the pulmonary circulation during exercise. This intrinsic imprecision may limit its use in clinical practice.

865 Increased Mean Pulmonary Artery Pressure on Right Heart Catheterization Affects Post-OLT Complications

2013 ◽  
Vol 144 (5) ◽  
pp. S-964
Author(s):  
Hye Yeon Jhun ◽  
Catherine T. Frenette ◽  
Maha Boktour ◽  
Arvind Bhimaraj ◽  
Jerry Estep ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Right Heart Catheterization ◽  
Heart Catheterization ◽  
Right Heart ◽  
Artery Pressure ◽  
Mean Pulmonary Artery Pressure

scholarly journals Sensitivity and Specificity of pulmonary artery pressure measurement in echocardiography and correlation with right heart catheterization

2021 ◽  
Vol 33 (3) ◽  
pp. 228-336
Author(s):  
Muhammad Adil Soofi ◽  
Muhammad Azam Shah ◽  
Ammar Mohammed AlQadhi ◽  
Abdulla Mofareh AlAnazi ◽  
Waleed M Alshehri ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Sensitivity And Specificity ◽  
Pressure Measurement ◽  
Right Heart Catheterization ◽  
Heart Catheterization ◽  
Right Heart ◽  
Artery Pressure

Right ventricular function and right heart catheterization as predictors of ECMO requirement in lung transplantation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Garcia Gomez ◽  
V Monivas ◽  
J Goicolea ◽  
J.F Oteo ◽  
J.L Campo-Canaveral De La Cruz ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Lung Transplantation ◽  
Right Ventricular ◽  
Pulmonary Artery Pressure ◽  
Life Support ◽  
Right Heart Catheterization ◽  
Heart Catheterization ◽  
Right Heart ◽  
Artery Pressure ◽  
Mean Pulmonary Artery Pressure

Abstract Introduction Lung transplantation (LT) often requires extracorporeal life support with extracorporeal membrane oxygenation (ECMO) because of several complications (included acute heart failure) during the intervention. Data on predictors of intraoperative ECMO use in these patients are scarce but it is an interesting topic because ECMO support has been linked to worse outcomes after LT. Purpose The main aim of our study is to assess which pre-surgical characteristics of right ventricular (RV) function and data from right heart catheterization (RHC) could help us to anticipate the need of ECMO in LT. Methods We conducted a retrospective observational study of all patients who underwent LT at our institution along 2018. We analysed data from echocardiogram (ECO) and RHC. All subjects underwent transthoracic echocardiography (TTE) according to the latest ASE/EACVI guidelines. Strain analysis was carried out by speckle-tracking echocardiography (QLAB 10.7, Philips). Results We included all 47 patients who underwent LT from January to December of 2018. They were middle age patients (52±11.8 years old) 51.1% men, 61.7% smokers (other cardiovascular risks: diabetes mellitus (8.5%), hypertension (23.4%) or dyslipidaemia (27.7%)). 24 (51%) of them needed intraoperative ECMO. 21 patients (45%) were evaluated by RHC before LT and ECO quality was good enough to evaluate different data in 41 patients (87%). Variables related to ECMO requirement vs non-ECMO use were: mean pulmonary artery pressure (23.1±7.3 vs 16.67±4.9 mmHg, p=0.027), mean transpulonary gradient (16.9±6.6 vs 8.9±3.6 mmHg, p=0.027) and diastolic transpulmonary gradient (9.8±8.1 vs 2.3±4.7 mmHg, p=0.002) from RHC and RV mid cavity diameter (3.4±0.8 vs 2.8±0.6 mm, p=0.001) from ECO. Besides this, free-wall RV longitudinal strain (FWRVLS) showed a tendency to be lower in patients who required ECMO (17.3±4.5% in vs 21.4±4.5%, p=0.072). Conclusion According to our results, RV mid cavity diameter measured by ECO and mean pulmonary artery pressure, mean and diastolic pulmonary gradients measured by RHC are useful tools to predict which patients could require ECMO during LT. FWRVLS showed an interesting tendency of lower values of it in LT using ECMO. This exploratory finding opens an important investigation line about a parameter which could help us to identify patients with subclinical right ventricle dysfunction. ROC curve Funding Acknowledgement Type of funding source: None

Sign in / Sign up

Export Citation Format

Share Document