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Review
. 2016 Jul 4:12:45-51.
doi: 10.1016/j.ijcha.2016.05.011. eCollection 2016 Sep.

Assessment of pulmonary artery pressure by echocardiography-A comprehensive review

Sathish Parasuraman  1 , Seamus Walker  2 , Brodie L Loudon  1 , Nicholas D Gollop  1 , Andrew M Wilson  1 , Crystal Lowery  1 , Michael P Frenneaux  3
Affiliations
Review

Assessment of pulmonary artery pressure by echocardiography-A comprehensive review

Sathish Parasuraman et al. Int J Cardiol Heart Vasc. .

Abstract

Pulmonary hypertension is a pathological haemodynamic condition defined as an increase in mean pulmonary arterial pressure ≥ 25 mmHg at rest, assessed using gold standard investigation by right heart catheterisation. Pulmonary hypertension could be a complication of cardiac or pulmonary disease, or a primary disorder of small pulmonary arteries. Elevated pulmonary pressure (PAP) is associated with increased mortality, irrespective of the aetiology. The gold standard for diagnosis is invasive right heart catheterisation, but this has its own inherent risks. In the past 30 years, immense technological improvements in echocardiography have increased its sensitivity for quantifying pulmonary artery pressure (PAP) and it is now recognised as a safe and readily available alternative to right heart catheterisation. In the future, scores combining various echo techniques can approach the gold standard in terms of sensitivity and accuracy, thereby reducing the need for repeated invasive assessments in these patients.

Keywords: Pulmonary acceleration time; Pulmonary hypertension by echo; Pulmonary pressure by echocardiography; Pulmonary vascular resistance by echo; Tricuspid Regurgitation Vmax.

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Figures

Fig. 1
Fig. 1
TR Vmax method for measuring PASP.
Fig. 2
Fig. 2
Pitfalls in TR peak measurement. A, B—Peak TR measurement with incomplete trace could lead to underestimation. C—Amputated jet could occur in severe TR that could lead to underestimation.
Fig. 3
Fig. 3
Pulmonary regurgitation method for measuring mean and diastolic pulmonary artery pressure.
Fig. 4
Fig. 4
RVOT acceleration time method for assessing pulmonary pressure. A—Pulmonary acceleration time measurement. B—Rapid rise and mid-systolic notching suggesting elevated pulmonary pressure.
Fig. 5
Fig. 5
Tricuspid regurgitation velocity-time integral method for measuring mPAP.
Fig. 6
Fig. 6
RV tissue Doppler method for assessing pulmonary pressure.
Fig. 7
Fig. 7
Right ventricular isovolemic relaxation time measurement.
Fig. 8
Fig. 8
Measurement of Tei index.
See this image and copyright information in PMC

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