Abstract 17748: Are Noninvasive Methods for Pasp Measurement Accurate When Compared to Invasive Pasp Measurements?
Background: The American Society of Echocardiography guidelines suggest utilizing agitated saline contrast or echocardiographic contrast agents if the TR (tricuspid regurgitation) signal is weak to assess pulmonary artery systolic pressure (PASP). There have been limited studies looking at accuracy between simultaneous Doppler derived PASP and invasive hemodynamic assessment. We aim to determine whether noninvasive PASP measurements at rest, utilizing agitated saline or the contrast agent Optison would give a more accurate assessment of PASP when compared to simultaneous invasive PASP assessment.
Methods: We prospectively enrolled 67 patients who underwent right heart catheterization and obtained simultaneous echocardiograms (8 patients were excluded due to inability to measure TR velocity). Invasive PASP values were compared with PASP obtained on echocardiogram at baseline, after agitated saline, and Optison in a sequential manner. Exclusion criteria included PASP > 60 mm Hg, history of intracardiac shunts, and congential heart disease.
Results: The mean age was 53 ±13 y, 63% male, 88% heart transplant recipients, average systolic blood pressure 131 ± 15 mm Hg, mean invasive PASP was 29 ±10 mmHg, and mean right atrial pressure was 8±5 mm Hg. Echocardiographic PASP with agitated saline showed the best correlation with invasive measurements. Echocardiographic PASP measurements made without the aid of agitated saline or Optison did not correlate well with invasive PASP measurements as well (Figure).
Conclusion: The use of agitated saline or Optison improved the correlation with invasive PASP measurements. Routine echocardiographic PASP measurements did not show a strong correlation with invasive PASP measurement. Larger scale studies need to be performed to assess whether agitated saline or echo contrast such as Optison has a better correlation with invasive PASP measurement.
Author Disclosures: N. Quader: None. B. Kane: None. K. Maganti: Research Grant; Significant; General Electric.
- © 2014 by American Heart Association, Inc.