Continuous wave doppler determination of right ventricular pressure: A simultaneous Doppler-catheterization study in 127 patients

Abstract

Simultaneous continuous wave Doppler echocardiography and right-sided cardiac pressure measurements were performed during cardiac catheterization in 127 patients. Tricuspid regurgitation was detected by the Doppler method in 117 patients and was of adequate quality to analyze in 111 patients. Maximal systolic pressure gradient between the right ventricle and right atrium was 11 to 136 mm Hg (mean 53 +/- 29) and simultaneously measured Doppler gradient was 9 to 127 mm Hg (mean 49 +/- 26); for these two measurements, r = 0.96 and SEE = 7 mm Hg. Right ventricular systolic pressure was estimated by three methods from the Doppler gradient. These were 1) Doppler gradient + mean jugular venous pressure; 2) using a regression equation derived from the first 63 patients (Group 1); and 3) Doppler gradient + 10. These methods were tested on the remaining 48 patients with Doppler-analyzable tricuspid regurgitation (Group 2). The correlation between Doppler-estimated and catheter-measured right ventricular systolic pressure was similar using all three methods; however, the regression equation produced a significantly better estimate (p less than 0.05). Use of continuous wave Doppler blood flow velocity of tricuspid regurgitation permitted determination of the systolic pressure gradient across the tricuspid valve and the right ventricular systolic pressure. This noninvasive technique yielded information comparable with that obtained at catheterization. Approximately 80% of patients with increased and 57% with normal right ventricular pressure had analyzable Doppler tricuspid regurgitant velocities that could be used to accurately predict right ventricular systolic pressure.

Echocardiographic abnormalities in sickle cell disease

“…Although right-heart catheterization is the gold standard for diagnosis of pulmonary hypertension, noninvasive estimation of PASP by continuous-wave Doppler ultrasound is a well-validated method for detection of pulmonary hypertension and correlates well with the PASP determined invasively by cardiac catheterization [14][15][16].…”

Increased renal formation of thromboxane A 2 and prostaglandin F 2α in heart failure

“…An average of six blood pressure and heart rate recordings (measured at 6:00, 8:00, and 12:00 AM and at 4:00, 8:00, and 12:00 PM) was taken as an index of the 24-hour study period. If tricuspid regurgitation was present, mean pulmonary artery pressure (PAPm) was determined by Doppler echocardiography according to the method described by Currie et al, 15 given that values thus obtained correlate well with those from invasive techniques. Only when tricuspid regurgitation was not present, PAPm was calculated by estimating pulmonary acceleration time, which has been shown to be directly and strongly correlated with PAPm.16 Venous pressure (VP) was determined by a direct method.…”

Clinical Impact and Prognosis of Pulmonary Hypertension after Transcatheter Aortic Valve Implantation

“…Pulmonary Artery Systolic Pressure (PASP) was calculated by adding trans tricuspid gradient to mean right atrial pressure. Trans tricuspid gradient was obtained from the maximum tricuspid regurgitation jet velocity in continuous-wave Doppler, and considered as equal to right ventricular systolic pressure in the absence of right ventricular obstruction [8,9]. Right atrial pressure was determined from the diameter of the inferior vena cava and its motion during respiration [5].…”