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. 2020 Oct-Dec;21(4):263-268.
doi: 10.4103/HEARTVIEWS.HEARTVIEWS_133_20. Epub 2021 Jan 14.

Assessment of Pulmonary Artery Pressures by Various Doppler Echocardiographic Parameters and its Correlation with Cardiac Catheterization in Patients with Pulmonary Hypertension

Arumugam Aashish  1 , Srinivasan Giridharan  1 , Selvaraj Karthikeyan  1 , Balasubramaniyan Amirtha Ganesh  1 , Palamalai Arun Prasath  1
Affiliations

Assessment of Pulmonary Artery Pressures by Various Doppler Echocardiographic Parameters and its Correlation with Cardiac Catheterization in Patients with Pulmonary Hypertension

Arumugam Aashish et al. Heart Views. 2020 Oct-Dec.

Abstract

Background: Measuring pulmonary artery pressures is a routine index in Doppler echocardiography to diagnose, risk stratify, and prognosticate patients with pulmonary hypertension (PH). There are numerous methods in use to measure it in routine clinical practice.

Objective: The objective of this study was to assess the correlation between the commonly used Doppler-derived parameters such as tricuspid regurgitation (TR)-derived systolic pulmonary artery pressure (SPAP), pulmonary regurgitation (PR)-derived mean pulmonary artery pressure (MPAP), and right ventricular outflow tract acceleration time (RVOT AcT) with right heart catheterization (RHC) data which are the gold standard.

Materials and methods: In this analytical study, we prospectively measured echo and angiogram parameters such as TR-derived SPAP, PR-derived MPAP, and RVOT AcT and studied its association with RHC data of thirty patients for a span of 2 years. Right ventricular AcT was also included in the study. Their relationship was displayed using Bland-Altman scatter plots. P < 0.05 was considered as statistically significant.

Results: Although both TR-derived SPAP and PR-derived MPAP had a moderate correlation with RHC-acquired data, the agreement between them was poor. RVOT AcT showed a strong inverse correlation with invasive MPAP.

Conclusion: Among the three Doppler methods that were assessed to measure pulmonary pressures, RVOT AcT had a strong correlation with MPAP. RVOT AcT of <80 ms had a high sensitivity to detect severe PH (defined as MPAP >45 mmHg). Hence, it is recommended to include AcT as a routine measure in the armamentarium of echocardiographic parameters used in patients with PH.

Keywords: Doppler echocardiography; pulmonary artery pressure; pulmonary hypertension; right heart catheterization.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
(a) Linear regression analysis plot of echocardiography and right heart catheterization of systolic pulmonary artery pressure (n = 30, r = 0.403, P= 0.027). (b) Bland–Altman plot of systolic pulmonary artery pressure measured by echocardiography and right heart catheterization
Figure 2
Figure 2
(a) Linear regression analysis plot of echocardiography and right heart catheterization of mean pulmonary artery pressure (n = 30, r = 0.429, P = 0.018). (b) Bland–Altman plot of mean pulmonary artery pressure measured by echocardiography using pulmonary regurgitation velocity and right heart catheterization
Figure 3
Figure 3
Correlation between mean pulmonary artery pressure and acceleration time (n= 30, r= −0.671, P< 0.001)
See this image and copyright information in PMC

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