657-662, 1984. A NUMBER of noninvasive methods for assessing right ventricular pressure have been developed based on physical examination results and the use of electrocardiograms, phonocardiograms, chest x-rays, and echocardiograms. ' '°While these methods can discriminate mild from severe right ventricular pressure elevation, they lack sufficient sensitivity to be useful in evaluating the effects of short-term therapeutic interventions or in monitoring the clinical course of outpatients.Recently The purpose of this study was to test the accuracy of the tricuspid gradient method in prospectively estimating right ventricular systolic pressures in a group of patients with Doppler-detected tricuspid regurgitation who underwent catheterization within 24 hr of their Doppler study. Material and methodsThe study group consisted of 62 patients in whom elevation of right-sided pressures was suspected on the basis of results of physical examination (loud pulmonic closure sound, right ventricular lift), chest x-ray (right ventricular enlargement, prominent pulmonary vasculature), and/or two-dimensional echocardiography (right ventricular chamber enlargement, "'D"-shaped left ventricle'0). Fifteen of the 62 patients were diagnosed as having clinical tricuspid regurgitation on the basis of results of physical examination by the primary ward physician. Criteria used for the clinical diagnosis of tricuspid regurgitation included systolic murmur with positive Carvallo's sign, prominent jugular venous "c-v" and hepatic pulsations, and right-sided S3. Specific criteria applied in a given case were not always stated in the medical record so we did not collate the incidence of such signs. The

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Background-A relatively simple, invasive method for quantitatively assessing the status of the coronary microcirculation independent of the epicardial artery is lacking. Methods and Results-By using a coronary pressure wire and modified software, it is possible to calculate the mean transit time of room-temperature saline injected down a coronary artery. The inverse of the hyperemic mean transit time has been shown to correlate with absolute flow. We hypothesize that distal coronary pressure divided by the inverse of the hyperemic mean transit time provides an index of microcirculatory resistance (IMR) that will correlate with true microcirculatory resistance (TMR), defined as the distal left anterior descending (LAD) pressure divided by hyperemic flow, measured with an external ultrasonic flow probe. A total of 61 measurements were made in 9 Yorkshire swine at baseline and after disruption of the coronary microcirculation, both with and without an epicardial LAD stenosis. The mean IMR (16.9Ϯ6.5 U to 25.9Ϯ14.4 U, Pϭ0.002) and TMR (0.51Ϯ0.14 to 0.79Ϯ0.32 mm Hg · mL Ϫ1 · min

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