The Use of Transthoracic Echocardiogram to Quantify Pulmonary Vascular Resistance in Patients with Systemic Sclerosis

Sophie Billet^{1

2}, Grégory Pugnet^{3

4}, Thomas Chollet^{1

2}, Gaétan Charbonnier^{1

2}, Pauline Fournier^{1

2}, Grégoire Prévot^{1

2}, Laurent Tetu^{1

2}, Maxime Cournot^{1

2}, Hélène Derumeaux^{1

2}, Didier Carrié^{1

2}, Michel Galinier^{1

2}, Olivier Lairez^{1

2}

Affiliations

¹ From the Department of Cardiology, Rangueil University Hospital; Cardiac Imaging Centre, Toulouse University Hospital; UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III; Medical School of Rangueil, University Paul Sabatier; Department of Internal Medicine, University Hospital of Purpan; Department of Pneumology, Larrey University Hospital, Toulouse; Department of Cardiology, La Réunion University Hospital, Saint-Pierre; INSERM, UMR 1188, Sainte-Clothilde; Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; Medical School of Purpan, University Paul Sabatier; Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France.
² S. Billet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Pugnet, MD, PhD, UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III, and Medical School of Rangueil, University Paul Sabatier, and Department of Internal Medicine, University Hospital of Purpan; T. Chollet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Charbonnier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; P. Fournier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Prévot, MD, Department of Pneumology, Larrey University Hospital; L. Tetu, MD, Department of Pneumology, Larrey University Hospital; M. Cournot, MD, PhD, Department of Cardiology, La Réunion University Hospital, and INSERM, UMR 1188, Sainte-Clothilde; H. Derumeaux, MD, PhD, Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; D. Carrié, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Purpan, University Paul Sabatier; M. Galinier, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier; O. Lairez, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier, and Department of Nuclear Medicine, Toulouse University Hospital.
³ From the Department of Cardiology, Rangueil University Hospital; Cardiac Imaging Centre, Toulouse University Hospital; UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III; Medical School of Rangueil, University Paul Sabatier; Department of Internal Medicine, University Hospital of Purpan; Department of Pneumology, Larrey University Hospital, Toulouse; Department of Cardiology, La Réunion University Hospital, Saint-Pierre; INSERM, UMR 1188, Sainte-Clothilde; Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; Medical School of Purpan, University Paul Sabatier; Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France. pugnet.g@chu-toulouse.fr.
⁴ S. Billet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Pugnet, MD, PhD, UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III, and Medical School of Rangueil, University Paul Sabatier, and Department of Internal Medicine, University Hospital of Purpan; T. Chollet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Charbonnier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; P. Fournier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Prévot, MD, Department of Pneumology, Larrey University Hospital; L. Tetu, MD, Department of Pneumology, Larrey University Hospital; M. Cournot, MD, PhD, Department of Cardiology, La Réunion University Hospital, and INSERM, UMR 1188, Sainte-Clothilde; H. Derumeaux, MD, PhD, Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; D. Carrié, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Purpan, University Paul Sabatier; M. Galinier, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier; O. Lairez, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier, and Department of Nuclear Medicine, Toulouse University Hospital. pugnet.g@chu-toulouse.fr.

PMID: 30824639
DOI: 10.3899/jrheum.180571

Free article

The Use of Transthoracic Echocardiogram to Quantify Pulmonary Vascular Resistance in Patients with Systemic Sclerosis

Sophie Billet et al. J Rheumatol. 2019 Nov.

Free article

. 2019 Nov;46(11):1495-1501.

doi: 10.3899/jrheum.180571. Epub 2019 Mar 1.

Authors

Affiliations

¹ From the Department of Cardiology, Rangueil University Hospital; Cardiac Imaging Centre, Toulouse University Hospital; UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III; Medical School of Rangueil, University Paul Sabatier; Department of Internal Medicine, University Hospital of Purpan; Department of Pneumology, Larrey University Hospital, Toulouse; Department of Cardiology, La Réunion University Hospital, Saint-Pierre; INSERM, UMR 1188, Sainte-Clothilde; Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; Medical School of Purpan, University Paul Sabatier; Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France.
² S. Billet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Pugnet, MD, PhD, UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III, and Medical School of Rangueil, University Paul Sabatier, and Department of Internal Medicine, University Hospital of Purpan; T. Chollet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Charbonnier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; P. Fournier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Prévot, MD, Department of Pneumology, Larrey University Hospital; L. Tetu, MD, Department of Pneumology, Larrey University Hospital; M. Cournot, MD, PhD, Department of Cardiology, La Réunion University Hospital, and INSERM, UMR 1188, Sainte-Clothilde; H. Derumeaux, MD, PhD, Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; D. Carrié, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Purpan, University Paul Sabatier; M. Galinier, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier; O. Lairez, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier, and Department of Nuclear Medicine, Toulouse University Hospital.
³ From the Department of Cardiology, Rangueil University Hospital; Cardiac Imaging Centre, Toulouse University Hospital; UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III; Medical School of Rangueil, University Paul Sabatier; Department of Internal Medicine, University Hospital of Purpan; Department of Pneumology, Larrey University Hospital, Toulouse; Department of Cardiology, La Réunion University Hospital, Saint-Pierre; INSERM, UMR 1188, Sainte-Clothilde; Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; Medical School of Purpan, University Paul Sabatier; Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France. pugnet.g@chu-toulouse.fr.
⁴ S. Billet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Pugnet, MD, PhD, UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III, and Medical School of Rangueil, University Paul Sabatier, and Department of Internal Medicine, University Hospital of Purpan; T. Chollet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Charbonnier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; P. Fournier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Prévot, MD, Department of Pneumology, Larrey University Hospital; L. Tetu, MD, Department of Pneumology, Larrey University Hospital; M. Cournot, MD, PhD, Department of Cardiology, La Réunion University Hospital, and INSERM, UMR 1188, Sainte-Clothilde; H. Derumeaux, MD, PhD, Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; D. Carrié, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Purpan, University Paul Sabatier; M. Galinier, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier; O. Lairez, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier, and Department of Nuclear Medicine, Toulouse University Hospital. pugnet.g@chu-toulouse.fr.

PMID: 30824639
DOI: 10.3899/jrheum.180571

Abstract

Objective: To explore the accuracy of tricuspid regurgitation velocity (TRV) to right ventricular outflow tract time-velocity integral (TVI_RVOT) ratio by Doppler to determine pulmonary vascular resistance (PVR) in patients with systemic sclerosis (SSc).

Methods: Thirty-five consecutive adult patients with SSc, fulfilling the 2013 European League Against Rheumatism/American College of Rheumatology classification criteria, with sinus rhythm referred for right heart catheterization (RHC), were retrospectively included. All patients underwent a transthoracic echocardiogram (TTE) performed within 24 h of RHC. Patients with SSc were recruited regardless of disease activity, cardiac symptoms, and treatment regimen. Doppler measurements were compared to RHC measurements. A linear regression equation was generated to predict PVR by echocardiogram based on the TRV/TVI_RVOT ratio. The accuracy of Doppler measurements for predicting PVR > 3 Wood units was assessed by computing the areas under the receiver-operating characteristic curves.

Results: There were 20 (57%) females in the study. The mean age was 65 ± 12 years. Mean and systolic pulmonary arterial pressures were 31 ± 8 and 53 ± 15 mmHg, respectively. There was a good correlation between TRV/TVI_RVOT ratio assessed by Doppler and PVR measured by RHC (R = 0.743, p < 0.001). The equation generated by this analysis was the following: PVR by Doppler = 11.3 × (TRV/TVI_RVOT) + 1.7. A cutoff value of 0.21 for TRV/TVI_RVOT ratio provided the best sensitivity (86%) and specificity (86%) to determine PVR > 3 Wood units.

Conclusion: Our study suggests that TTE using Doppler could be a useful and noninvasive tool for estimating PVR in patients with SSc.

Keywords: PULMONARY HYPERTENSION; SYSTEMIC SCLEROSIS; TRANSTHORACIC ECHOCARDIOGRAM.

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The Use of Transthoracic Echocardiogram to Quantify Pulmonary Vascular Resistance in Patients with Systemic Sclerosis

Affiliations

The Use of Transthoracic Echocardiogram to Quantify Pulmonary Vascular Resistance in Patients with Systemic Sclerosis

Authors

Affiliations

Abstract

MeSH terms

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Medical

Research Materials