Correlation between Doppler echocardiography and right heart catheterization assessment of systolic pulmonary artery pressure in patients with severe aortic stenosis

Abstract

Objectives The aim of this study was to investigate reliability and accuracy of noninvasive measurement method by echocardiography compared to invasive measurement of systolic pulmonary artery pressure (SPAP) in a large cohort of aortic stenosis (AS) patients. Background Pulmonary hypertension (PH) is common in patients with cardiac disease, especially in left heart disease like severe AS. Invasive measurement by right heart catheterization (RHC) is the gold standard to assess pulmonary pressures. Nevertheless, echocardiography is widely used in everyday practice for estimation of pulmonary pressures and diagnosing PH. Methods A total of 1400 patients with AS and full invasive hemodynamic assessment by RHC and noninvasive measurements by Doppler echocardiography were included. Results Mean patient age was 81.5 ± 6.8 years, and 46.3% were males. SPAP was 44.7 ± 15.1 mm Hg by echocardiography and 45.3 ± 15.2 mm Hg by RHC. Pearson's correlation coefficient was r = .820 (P < .0001). Bland–Altman analysis showed a bias of −0.56 mm Hg (95% limits of agreement −18.38 to + 17.26 mm Hg) and 80.6% measurement accuracy. Pulmonary hypertension defined by RHC as a mean PAP ≥25 mm Hg was reliably diagnosed via an echocardiographically measured SPAP of >40 mm Hg (82.2% sensitivity, 80.2% specificity, 83.1% positive predictive value, 79.2% negative predictive value). Conclusions In a large cohort of patients with severe aortic stenosis, we could demonstrate a very good correlation of SPAP between Doppler echocardiography and invasive RHC measurement. Pulmonary hypertension could be diagnosed by echocardiography with high sensitivity and specificity.

Dapagliflozin reduces pulmonary vascular damage and susceptibility to atrial fibrillation in right heart disease

“…Besides, research has also suggested that the non‐invasive evaluation of pulmonary arterial pressure by transthoracic echocardiography (TTE) correlates well with invasive measurements, and it is a reliable method for the assessment of pulmonary circulation 19,20 . Moreover, TTE is very suitable for the non‐invasive diagnosis of PAH and has an acceptable specificity and sensitivity in detecting PAH 21 . Therefore, we comprehensively evaluated the cardiac structure and function through TTE and blood pressure metre.…”

Systolic Pulmonary Artery Pressure and Cardiovascular Biomarkers—New Non-Invasive Ways to Detect Pulmonary Hypertension in Patients with Severe Aortic Valve Stenosis Undergoing TAVR?

“…An sPAP ≥40 mmHg was used as the cut-off value to determine PH in accordance with the current literature [22][23][24]. In particular, Schewel et al [25] compared echocardiographically obtained sPAP with invasively RHC obtained sPAP data. The correlation coefficient of r = 0.820 was in a very satisfactory range.…”

Comparability between Computed Tomography Morphological Vascular Parameters and Echocardiography for the Assessment of Pulmonary Hypertension in Patients with Severe Aortic Valve Stenosis—Results of a Multi-Center Study

“…The simplified Bernoulli equation (4 × TRV 2 ) + RAP was applied to obtain a sPAP result. Different sPAP (40, 45 and 50 mmHg) values were used to determine PH in accordance with the current literature [ 10 , 11 , 12 , 13 , 14 ]. An illustration about the echocardiographic measurement is provided in Figure 1 .…”