A Novel Non-Invasive Method for Estimating Elevated Pulmonary Vascular Resistance Based on Echocardiographic Assessment of Pulmonary Artery Wave Reflection
| Autor: | Satomi Adachi-Akahane, Yukio Hiroi, Hiromasa Hayama, Masao Moroi, Tokuhisa Uejima, Hisao Hara |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
Cardiac Catheterization
medicine.medical_specialty Hypertension Pulmonary Hemodynamics Regurgitation (circulation) Pulmonary Artery Doppler echocardiography medicine.artery Internal medicine medicine Humans Ventricular outflow tract medicine.diagnostic_test business.industry General Medicine medicine.disease Pulmonary hypertension Catheter medicine.anatomical_structure Lead Echocardiography Pulmonary artery Vascular resistance Cardiology Vascular Resistance Cardiology and Cardiovascular Medicine business |
| Zdroj: | Circulation Journal. 86:947-955 |
| ISSN: | 1347-4820 1346-9843 |
| DOI: | 10.1253/circj.cj-21-0646 |
| Popis: | Several non-invasive methods for pulmonary vascular resistance (PVR) measurement are proposed, but none are sufficiently accurate for use in clinical practice. This study proposes a new echocardiographic method of pulmonary artery wave reflection and investigates its efficacy in managing patients with pulmonary hypertension.Methods and Results:In total, 83 patients with left heart disease, pulmonary arterial hypertension, and chronic thromboembolic pulmonary hypertension (CTEPH), who underwent Doppler echocardiography and right heart catheterization, were included in the study. Pulmonary artery wave reflection was characterized by separating the pulmonary artery pressure waveform into forward and backward (Pb) waves, based on wave intensity. Pulmonary artery pressure waveforms were estimated from continuous Doppler tracings of tricuspid regurgitation velocity, and flow velocity was measured using pulsed Doppler of the right ventricular outflow tract. Pb-peak was compared with catheter hemodynamic indices, and with PVR by Abbas 2003, 2013 and Haddad in relation to increased catheter PVR. Catheter PVR and Pb were strongly correlated (r=0.77, P0.001). The areas under the receiver operator characteristic curve for Pb-peak, PVR by Abbas 2003, 2013 and Haddad were 0.91, 0.72, 0.80, and 0.80, respectively, and were used to detect an increase in PVR (3 Woods units).This study describes a novel, simple, and non-invasive echocardiography method to assess pulmonary wave reflected pressure to identify patients with pulmonary hypertension due to increased PVR. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|