Abstract 1578: Non-invasive Estimation of Right Atrial Pressure Using Tissue Doppler Imaging
Background: Right atrial pressure (RAP) has important prognostic implications in patients with heart failure and pulmonary hypertension. However, non-invasive evaluation of RAP by echocardiography can be challenging.
Purpose: To perform tissue Doppler imaging of the tricuspid annulus and assess correlation with invasively determined RAP.
Methods: We prospectively evaluated 42 patients (mean age 52 ± 11; 24 males; left ventricular ejection fraction 46 ± 18%) who underwent pulsed tissue Doppler imaging of the tricuspid annulus and right heart catheterization within 24 hours of each other. Patients with a history of cardiac transplantation or complex congenital heart disease were excluded. Tricuspid annular peak systolic (Sa), early diastolic (Ea), and late diastolic (Aa) velocities were measured from the lateral tricuspid annulus and correlated with RAP determined via catheterization.
Results: For the entire study population, mean values were as follows: peak Sa 11.4 ± 2.7 cm/s, peak Ea 9.6 ± 3.5 cm/s, peak Aa 11.6 ± 4.9 cm/s, and RAP 9 ± 5 mm Hg. While peak Sa and Ea did not correlate with RAP, peak Aa demonstrated a significant inverse correlation with RAP (r = −0.66; p < 0.001; see figure⇓). Peak Aa < 11 cm/s predicted an elevated RAP ≥ 10 mm Hg with 80% sensitivity and 81% specificity. Positive and negative predictive values were 71% and 88% respectively.
Conclusion: Peak Aa of the tricuspid annulus demonstrates a significant inverse correlation with RAP. It is easily obtainable in patients in sinus rhythm and has potential clinical utility in the non-invasive determination of RAP.