Noninvasive Evaluation of Right Atrial Pressure

Beigel, Roy; Cercek, Bojan; Luo, Hao; Siegel, Robert J.

doi:10.1016/j.echo.2013.06.004

Cited by 202 publications

(161 citation statements)

References 63 publications

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“…In comparison with currently used semiquantitative Doppler echocardiographic methods for estimation of the right atrial pressure, 3 our new quantitative method might be a better choice.…”

Section: Discussionmentioning

confidence: 99%

“…The most widely used method is to assume that the distance between the sternal angle and the center of RA is 5 cm regardless of the posture of the patients. [1][2][3]11 While by rigorous assessment of the sternal angle-RA distance, Seth et al 17 had proven that the vertical distance from sternal angle to the level of mid-RA varies considerably between individuals and with patient's different positions. Another method to mark the mid-RA is to find the intersection of the midaxillary line and a perpendicular extended to the fourth intercostal space at the sternum.…”

Section: Discussionmentioning

confidence: 99%

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New Method for Noninvasive Quantification of Central Venous Pressure by Ultrasound

Xing

Liu

Zhao

et al. 2015

Circ: Cardiovascular Imaging

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Background— The central venous pressure (CVP) is essential for assessing the cardiac preload and circulating blood volume in clinic. The invasive CVP measurement by central venous catheter has been reported with various complications. The aim of this study was to develop a new noninvasive method for quantification of CVP by ultrasound. Methods and Results— Seventy-six patients who had their CVP monitored for intraoperative or postoperative management were recruited. By accurate location of the collapse point of the internal jugular vein and the center of the right atrium using ultrasound imaging, the height of the fluid column between those 2 points was measured as the noninvasive CVP (CVPn). A total of 118 measurements were performed and compared with the invasive CVP (CVPi). Linear correlation analysis revealed a significant correlation between CVPi and CVPn (preoperative measurements, r =0.90; P <0.01 and postoperative measurements, r =0.93; P <0.01). Bland–Altman plots showed a good agreement between CVPi and CVPn with the mean difference of 0.22 mm Hg (preoperative measurements) and −0.09 mm Hg (postoperative measurements), respectively. Conclusions— The new noninvasive CVP quantification method based on the location of both the collapse point of internal jugular vein and the center of right atrium by ultrasound could be used as a reliable approach for monitoring the hemodynamic status in clinic.

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“…In comparison with currently used semiquantitative Doppler echocardiographic methods for estimation of the right atrial pressure, 3 our new quantitative method might be a better choice.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

New Method for Noninvasive Quantification of Central Venous Pressure by Ultrasound

Xing

Liu

Zhao

et al. 2015

Circ: Cardiovascular Imaging

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“…An IVC diameter of >2 cm that collapses by <50% with a sniff suggests a high RAP of 15 mmHg (range: 10-20 mmHg). 113,115 In children, the IVC varies with age of the patient. Elevated RAP in children can be assessed by the percentage of collapse of the IVC during inspiration rather than by an absolute number.…”

Section: Rv and Ra Enlargementmentioning

confidence: 99%

Transthoracic Echocardiography in the Evaluation of Pediatric Pulmonary Hypertension and Ventricular Dysfunction

et al. 2016

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Transthoracic echocardiography (TTE) is the most accessible noninvasive diagnostic procedure for the initial assessment of pediatric pulmonary hypertension (PH). This review focuses on principles and use of TTE to determine morphologic and functional parameters that are also useful for follow-up investigations in pediatric PH patients. A basic echocardiographic study of a patient with PH commonly includes the hemodynamic calculation of the systolic pulmonary artery pressure (PAP), the mean and diastolic PAP, the pulmonary artery acceleration time, and the presence of a pericardial effusion. A more detailed TTE investigation of the right ventricle (RV) includes assessment of its size and function. RV function can be evaluated by RV longitudinal systolic performance (e.g., tricuspid annular plane systolic excursion), the tricuspid regurgitation velocity/right ventricular outflow tract velocity time integral ratio, the fractional area change, tissue Doppler imaging-derived parameters, strain measurements, the systolic-to-diastolic duration ratio, the myocardial performance (Tei) index, the RV/left ventricle (LV) diameter ratio, the LV eccentricity index, determination of an enlarged right atrium and RV size, and RV volume determination by 3-dimensional echocardiography. Here, we discuss the potential use and limitations of TTE techniques in children with PH and/or ventricular dysfunction. We suggest a protocol for TTE assessment of PH and myocardial function that helps to identify PH patients and their response to pharmacotherapy. The outlined protocol focuses on the detailed assessment of the hypertensive RV; RV-LV crosstalk must be analyzed separately in the evaluation of different pathologies that account for pediatric PH.

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“…5) and TV annulus E/E′> 6 indicates elevated RAP > 10 mm Hg. 20 The TV E′, E velocity, and VTI across TV can be obtained from the ME4C, TGRVI, TGRVI/O, or DTGLAX views (Fig. 6).…”

Section: Estimation Of Rapmentioning

confidence: 99%

Transesophageal Echocardiographic Approach to a Patient with Suspected Pulmonary Hypertension in the Intraoperative Period

Kumar¹,

Puri²

2017

Journal of Perioperative Echocardiography

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Pulmonary hypertension (PH) defined by a mean pulmonary artery pressure (MPAP) >25 mm Hg at rest is confirmed by right heart catheterization (RHC). With the rapid development of surgical methods and cardiopulmonary bypass strategies, many children and adults are undergoing surgical correction for their cardiac pathologies. Presence of PH in these patients contributes to a major morbidity and poses a great challenge for the operative team during its surgical and postoperative management. With the universal use of transesophageal echocardiography (TEE) in almost all cardiac surgeries, the etiology, severity of PH, and its effect on cardiac structures and function can be evaluated in patients suspected of having PH. Since there is no established algorithm for the intraoperative TEE evaluation of such patients, we proposed an algorithm for the evaluation of PH in patients suspected of having raised pulmonary pressure using TEE in the intraoperative period.

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Noninvasive Evaluation of Right Atrial Pressure

Cited by 202 publications

References 63 publications

New Method for Noninvasive Quantification of Central Venous Pressure by Ultrasound

New Method for Noninvasive Quantification of Central Venous Pressure by Ultrasound

Transthoracic Echocardiography in the Evaluation of Pediatric Pulmonary Hypertension and Ventricular Dysfunction

Transesophageal Echocardiographic Approach to a Patient with Suspected Pulmonary Hypertension in the Intraoperative Period

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