Use of echocardiographic pulmonary acceleration time and estimated vascular resistance for the evaluation of possible pulmonary hypertension

Cardiovascular Ultrasound

Research

Sven-Olof Granstam¹  Magnus W Roos¹  Gerhard Wikström²  Erik Björklund² 

[1]Department of Medical Sciences Clinical Physiology, Uppsala University, Uppsala, Sweden

[2]Department of Medical SciencesCardiology, Uppsala University, Uppsala, Sweden

关键词: Echocardiography;    Right heart catheterization;    Acceleration time;    Systolic pulmonary pressure;    Pulmonary vascular resistance;    Pulmonary hypertension;   

DOI  :  10.1186/1476-7120-11-7

 received in 2013-01-18, accepted in 2013-02-15,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundDuring ultrasound examination, tricuspid regurgitation may be absent or gives a signal that is not reliable for the estimation of systolic pulmonary pressure. The aim of this study was to evaluate the usefulness of acceleration time (AT) from the right ventricular outflow tract (RVOT) as an estimation of the trans-tricuspid valve gradient (TTVG) and to investigate the correlation between estimated and invasive pulmonary vascular resistance (PVR).MethodsThe AT was correlated to the TTVG measured with routine standard echocardiography in 121 patients. In a subgroup of 29 patients, systolic pulmonary pressure (SPAP) and mean pulmonary arterial pressure (MPAP) were obtained from recent right heart catheterization (RHC).ResultsWe found no significant correlation between the estimation of right atrial pressure (RAP) by echocardiography and the RAP obtained by RHC. Estimated SPAP (TTGV + RAP mean from RHC) showed a good linear relation to invasively measured SPAP. TTVG and AT showed a non-linear relation, similar to SPAP and MPAP measured by catheterization and AT. For detection of SPAP above 38 mmHg a cut-off for AT of 100 ms resulted in a sensitivity of 89% and a specificity of 84%. For detection of MPAP above 25 mmHg a cut-off for AT of 100 ms resulted in similar sensitivity and specificity. Invasive PVR and the ratio of TTVG and the time velocity integral of the RVOT (TVI RVOT ) had a strong linear relation.ConclusionsOur study confirms that AT appears to be useful for the evaluation of pulmonary hypertension. In high risk patients, an AT of less than 100 ms indicates a high probability of pulmonary hypertension. Furthermore, PVR estimation by ultrasound seems preferably be done by using the ratio of TTVG and TVI RVOT.

【 授权许可】

CC BY   
© Granstam et al.; licensee BioMed Central Ltd. 2013