Diagnostic accuracy of echocardiography for pulmonary hypertension: a systematic review and meta-analysis

Janda, Surinder; Shahidi, Neal; Gin, Kenneth; Swiston, John R.

doi:10.1136/hrt.2010.212084

Cited by 321 publications

(228 citation statements)

References 66 publications

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“…Various echocardiographic modalities have been utilised in the estimation of sPAP including tissue doppler echocardiography (DE), measurement of the tricuspid annular plane systolic excursion, two-dimensional strain, speckle tracking, acceleration time across the pulmonary valve, the pulmonary artery regurgitant jet method and the tricuspid regurgitant jet method [46]. …”

Section: Limitations Of Current Knowledgementioning

confidence: 99%

Pulmonary Hypertension in Renal Disease: Epidemiology, Potential Mechanisms and Implications

et al. 2013

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Pulmonary hypertension (PH) is highly prevalent in end-stage renal disease. Several observational studies, based on an echocardiographic diagnosis of PH, have suggested a prevalence of 30-60% and an association with increased mortality and poorer outcome following renal transplantation. The pathogenesis of PH in this population remains poorly understood. Reported associations include arteriovenous fistulae, cardiac dysfunction, fluid overload, bone mineral disorder and non-biocompatible dialysis membranes. However, due to the small numbers, the cross-sectional nature of the majority of studies in this field, and the reliance on echocardiography for the diagnosis of PH, no consistent association with any individual risk factor has been demonstrated. There is no difference in prevalence between patients receiving different dialysis modalities and emerging evidence suggests that the onset of the condition may precede dialysis treatment in many patients. Furthermore, little is known about the impact of the ‘uraemic vasculopathy' on the pulmonary vasculature. Given the similarities between vascular changes in uraemia and those seen in pulmonary arterial hypertension, it is possible that a pulmonary vasculopathy may be present in a proportion of patients. There is a need for better understanding of the natural history and the pathogenesis of the condition which would help to individualise treatment of PH in end-stage renal disease. To enable such understanding, prospective adequately powered studies with an integrated investigational approach including right heart catheterisation are needed.

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Section: Limitations Of Current Knowledgementioning

confidence: 99%

Pulmonary Hypertension in Renal Disease: Epidemiology, Potential Mechanisms and Implications

et al. 2013

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“…(n=736; 6 исследований) [24], S. Janda и соавт. (n=1485; 29 исследо-ваний) [25] и M. Taleb и соавт. (n=522; 9 исследований) [26] были посвящены оценке чувствительности и специфично-сти ЭхоКГ в оценке СДЛА.…”

Section: результатыunclassified

“…Точность, вычисленная М. Taleb и соавт. [26], была низкой (73%), и хотя во всех трех метаанализах отмечалась высо-кая чувствительность (82; 83 и 88% соответственно), спе-цифичность оказалась недостаточной (68; 72 и 56% соот-ветственно) [24][25][26].…”

Section: результатыunclassified

“…3, а). Более высокий показатель точ-ки разделения, чем в вышеописанных исследованиях [24][25][26], равный используемому в практике пограничному значению СДЛА по ЭхоКГ -40 мм рт. ст., показывает большую специфичность для диагноза ЛГ, но приводит к появлению ложноотрицательных результатов (у 7 паци-ентов нашей когорты диагноз ЛГ был установлен только на основании катетеризации).…”

Section: результатыunclassified

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Possibilities for Echocardiographic Determination of Pulmonary Artery Pressure in Patients With Systemic Connective Tissue Diseases: Data of a Rheumatology Expert Center

Николаева¹,

Корсакова²,

Курмуков³

et al. 2015

rsp

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“…Although the Bernoulli method is generally accepted and used in daily practice, there is still debate regarding its validity, with some studies not being able to reproduce the high correlation with invasive measurements. 10 The inaccuracies in estimation (mostly underestimation) of SPAP are mostly attributable to certain patient populations such as those with emphysema, or when either the tricuspid regurgitation jet tracing is not complete or in the presence of wide-open tricuspid regurgitation. Also, in the setting of very high right atrial pressure, in which echocardiography may not accurately estimate right atrial pressure, the SPAP estimate will be affected.…”

Section: Pulmonary Artery Pressurementioning

confidence: 99%

Echo-Doppler Hemodynamics

et al. 2015

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A 52-year-old man with dilated cardiomyopathy (left ventricular ejection fraction 25%), recently discharged from a heart failure (HF) admission, presented to the office with weakness and shortness of breath. On examination, his weight was stable, his blood pressure was 88/60 mm Hg, his jugular veins were difficult to assess owing to obesity, with a few bibasilar crackles, distant heart sounds with a 2/6 holosystolic murmur and a soft S3, a protruding abdomen, and 1 to 2+ pitting lower-extremity edema. Laboratory results showed a rise in creatinine from 1.5 to 2.6 mg/dL, a rise in serum urea nitrogen from 38 to 52 mg/dL, and a rise in brain natriuretic peptide from 106 to 280 pg/mL. This patient presented a clinical challenge, because it was not clear whether his symptoms were related to progressive HF with worsening cardiorenal syndrome, or conversely, to relative hypovolemia. Unfortunately, physical examination and laboratory studies can be misleading in the setting of HF exacerbation, 1 and changes in weight are known to lag behind important hemodynamic shifts. 2Traditionally, this patient would likely have been hospitalized, with consideration of right heart catheterization if hemodynamic assessment were needed to guide further treatment. However, in our efforts to improve the quality and safety of care, with potentially competing imperatives to reduce readmissions, length of stay, and costs, 3 we must revisit our approach. The use of pulmonary artery flotation catheter monitoring requires intensive care unit or specialty unit hospitalization, has significant procedure-related risks, may not be accurate in all A and B, The inferior vena cava is 2.6 cm in diameter, without respiratory collapse during inspiration (Ins), consistent with an elevated CVP. This is opposed to a patient with a small IVC (C and D) with inspiratory collapse, consistent with a normal CVP. IVC indicates inferior vena cava.

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Diagnostic accuracy of echocardiography for pulmonary hypertension: a systematic review and meta-analysis

Cited by 321 publications

References 66 publications

Pulmonary Hypertension in Renal Disease: Epidemiology, Potential Mechanisms and Implications

Pulmonary Hypertension in Renal Disease: Epidemiology, Potential Mechanisms and Implications

Possibilities for Echocardiographic Determination of Pulmonary Artery Pressure in Patients With Systemic Connective Tissue Diseases: Data of a Rheumatology Expert Center

Echo-Doppler Hemodynamics

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