Abstract 8951: Assessment of Pressure Reflection in the Pulmonary Circulation Using Echocardiography Identifies Patients with Normal as Well as Increased Pulmonary Vascular Resistance
Background and aim. Pulmonary hypertension (PH) is a frequent finding in patients with cardiopulmonary disorders. It is important to recognize PH due to increased pulmonary vascular resistance (PVR). In a recent study we describe a new echocardiography method to identify patients with increased PVR (>3 WU) based on detection of pressure reflection (PR) in the pulmonary artery (PA). The patient population was biased towards high PVR and therefore, in the present study we evaluate the method in a more representative population undergoing right heart catheterization.
Methods and results. Echocardiography and catheterization were performed within one week in 108 patients. We selected 3 variables related to PR: the interval from valve opening to peak velocity in the PA (AcT, ms), the interval between PA peak velocity and peak tricuspid velocity (tPV-PP, ms), and the right ventricular pressure increase after peak velocity in the PA (augmented pressure, AP, mm Hg). Cut-of values indicating increased PVR for Act/tPV-PP/AP were 89 ms/>8 mmHg. Forty-six percent had left heart disease, 21% were heart transplant patients and 18% had pulmonary arterial hypertension. The proportion with increased PAMP (>25 mmHg) was 54%, increased pulmonary capillary wedge pressure (PCWP>12 mHg) 40%, increased PVR (>3 WU) 36% or both increased PVR and PCWP 15%. The table shows how the number of PR variables affected the diagnostic performance. The positive predictive value was 94% with equal to or > 2 PR variables and the negative predictive value was 92% with no PR variables present.
Conclusions. Assessment of PR in the pulmonary circulation identifies patients with normal as well as increased PVR.
- © 2011 by American Heart Association, Inc.