Assessment of Pulmonary Vascular Resistance by Doppler Echocardiography in Patients With Pulmonary Arterial Hypertension

Selimovic, Nedim; Rundqvist, Bengt; Bergh, Claes‐Håkan; Andersson, Bert; Petersson, S.; Johansson, Lena; Bech‐Hanssen, Odd

doi:10.1016/j.healun.2007.06.008

Cited by 61 publications

(49 citation statements)

References 26 publications

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“…In patients with PAH, we have shown in a recent study that PVR can be calculated with a strong correlation (Rϭ0.93) between catheter and Doppler methods. 16 These results were obtained in a group of patients with normal PCWP and a relatively high PA mean pressure. RVET indicates right ventricular ejection time; RR, interval between 2 heart beats.…”

Section: Discussionmentioning

confidence: 81%

Echocardiography Can Identify Patients With Increased Pulmonary Vascular Resistance by Assessing Pressure Reflection in the Pulmonary Circulation

Bech‐Hanssen

Lindgren

Selimovic

et al. 2010

Circ: Cardiovascular Imaging

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Background-Pulmonary hypertension is a frequent finding in patients with cardiopulmonary disorders. It is important to recognize pulmonary hypertension due to increased pulmonary vascular resistance (PVR), as this affects treatment and prognosis. Patients with increased PVR have an increased pulmonary pressure reflection. We hypothesized that pressure reflection can be described by echocardiography and that variables related to pressure reflection can identify patients with increased PVR. Methods and Results-The study comprised 98 patients investigated within 24 hours of right heart catheterization and 20 control subjects. The pressure reflection variables were obtained by pulsed Doppler in the pulmonary artery and continuous Doppler of tricuspid regurgitation. We selected 3 variables related to pressure reflection: the interval from valve opening to peak velocity in the pulmonary artery (AcT, ms), the interval between pulmonary artery peak velocity and peak tricuspid velocity (tPV-PP, ms), and the right ventricular pressure increase after peak velocity in the pulmonary artery (augmented pressure, AP, mm Hg). The correlation between simultaneous catheter-and echocardiographydetermined AP was strong (nϭ19, Rϭ0.83). The AcT, tPV-PP, and AP in patients with a PVR of Ͼ3 Woods units (nϭ71) was (meanϮSD) 77Ϯ16 ms, 119Ϯ36 ms, and 22Ϯ12 mm Hg, respectively, and differed from patients with a PVR of Յ3 Woods units (nϭ27, PϽ0.0001), 111Ϯ32 ms, 39Ϯ54 ms, and 3Ϯ4 mm Hg, and from controls, 153Ϯ32 ms, Ϫ19Ϯ45 ms, and 0 mm Hg, respectively (PϽ0.0001). The AcT, tPV-PP, and AP values were not correlated with capillary wedge pressure (Rϭ0.08 -0.16). The areas under the receiver operator characteristic curve (95% CI) for AcT, tPV-PP, and AP were 0.87 (0.82 to 0.95), 0.94 (0.89 to 0.99), and 0.98 (0.95 to 1.0), respectively. Conclusions-In this study, we describe a novel echocardiography method for assessing pressure reflection in the pulmonary circulation. This method can be used to identify patients with pulmonary hypertension due to increased PVR. (Circ Cardiovasc Imaging. 2010;3:424-432.)

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Section: Discussionmentioning

confidence: 81%

Echocardiography Can Identify Patients With Increased Pulmonary Vascular Resistance by Assessing Pressure Reflection in the Pulmonary Circulation

Bech‐Hanssen

Lindgren

Selimovic

et al. 2010

Circ: Cardiovascular Imaging

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“…(17) In addition, the finding of an increased RV systolic time interval is a highly specific echocardiographic sign of PH, albeit one with low sensitivity. (16) Other echocardiographic signs, such as right heart enlargement, pericardial effusion, RV dysfunction, paradoxical interventricular septal motion, and reduced LV filling volumes, also corroborate the presence of PH ( Figure 3). (18) Provided that their limitations are taken into account and that they are evaluated and interpreted in the light of the clinical context, all these parameters can be useful in the diagnosis and follow-up of patients with PH.…”

Section: Echocardiographymentioning

confidence: 75%

“…(15) It is also possible to estimate pulmonary vascular resistance, which correlates with invasive hemodynamic measurement. (16) Atrial contraction and the subsequent increase in intracavitary pressure result in the formation of a characteristic wave, known as the A-wave. hemangiomatosis, fibrosing mediastinitis, pulmonary vasculitis, and pulmonary artery sarcoma.…”

Section: Echocardiographymentioning

confidence: 99%

O papel dos exames de imagem na avaliação da circulação pulmonar

et al. 2011

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O conhecimento sobre a estrutura e a função da circulação pulmonar evoluiu sensivelmente nas últimas décadas. A utilização de exames de imagem não invasivos para a avaliação da anatomia e da função dos vasos pulmonares e do coração ganhou ainda mais importância com o advento de tratamentos até então indisponíveis. Além do auxílio para o diagnóstico, as informações obtidas têm se mostrado fundamentais para o estabelecimento de prognósticos e como parâmetro de sucesso dos tratamentos. A presente revisão discute os diversos métodos que podem ser utilizados para a avaliação da circulação pulmonar por imagens existentes nos dias de hoje, desde técnicas amplamente disponíveis e de relativa baixa complexidade técnica, como a radiografia de tórax, até métodos complexos e promissores, como a tomografia de impedância elétrica

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“…Such measurements include tricuspid annular plane systolic excursion (TAPSE) as a measure of RV ejection fraction, [6][7][8] RV outfl ow tract velocity-time integral (RVOT VTI) as a surrogate for stroke volume, and the presence of "notching" in the Doppler fl ow velocity envelope obtained from the RVOT, indicating elevated pulmonary vascular resistance (PVR). 9,10 We information and RHC tracings (B. N. R.-L.) (Prosolv CardioVascular, FUJIFILM Holdings America Corp). Thirty percent of the echocardiograms were evaluated by a second physician (P. R. F.) blinded to the fi rst read, to assess interobserver reliability.…”

Section: Original Research Diffuse Lung Diseasementioning

confidence: 99%

Echocardiographic and Hemodynamic Predictors of Mortality in Idiopathic Pulmonary Fibrosis

Rivera‐Lebron

Forfia

Kreider

et al. 2013

Chest

105

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Idiopathic pulmonary fi brosis (IPF) is a fatal disease with a variable natural history. Pulmonary hypertension (PH) is frequently found in patients with IPF and is associated with an almost threefold increase in the risk of death. 1,2 In pulmonary arterial hypertension (PAH), outcome is directly related to the capacity of the right ventricle (RV) to adapt to elevated afterload. 3 However, the role of RV function is not clearly understood in pulmonary vascular disease related to IPF.Although right-sided heart catheterization (RHC) is the gold standard modality for hemodynamic assessment, Doppler echocardiogram is a complementary method of assessing RV function. While Doppler echocardiogram measurement of the right ventricular systolic pressure (RVSP) has limited accuracy in advanced lung disease, 4,5 several echocardiographic measurements of the RV have been associated with outcomes in PH. Such measurements include tricuspid annular plane systolic excursion (TAPSE) as a measure of RV ejection fraction, 6-8 RV outfl ow tract velocity-time integral (RVOT VTI) as a surrogate for stroke volume, and the presence of "notching" in the Doppler fl ow velocity envelope obtained from the RVOT, indicating elevated pulmonary vascular resistance (PVR). 9,10 We

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Assessment of Pulmonary Vascular Resistance by Doppler Echocardiography in Patients With Pulmonary Arterial Hypertension

Cited by 61 publications

References 26 publications

Echocardiography Can Identify Patients With Increased Pulmonary Vascular Resistance by Assessing Pressure Reflection in the Pulmonary Circulation

Echocardiography Can Identify Patients With Increased Pulmonary Vascular Resistance by Assessing Pressure Reflection in the Pulmonary Circulation

O papel dos exames de imagem na avaliação da circulação pulmonar

Echocardiographic and Hemodynamic Predictors of Mortality in Idiopathic Pulmonary Fibrosis

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