[The value of recording the pulmonary insufficiency flow by continuous Doppler for the evaluation of systolic pulmonary artery pressure].
Systolic, diastolic and mean pulmonary artery pressures can be evaluated by Doppler recordings of the maximal velocity of tricuspid regurgitation and early and late diastolic pulmonary regurgitant flow. The aim of this study was to assess the reliability of the calculation of systolic pulmonary artery pressure from pulmonary regurgitant flow by comparing the values with those obtained from the tricuspid regurgitant flow in the same patient. With this objective in mind, we investigated 70 patients with an average age of 45 +/- 34 years, in sinus rhythm, all of whom had tricuspid and pulmonary regurgitant jets which could be recorded with continuous wave Doppler. Systolic pulmonary artery pressure was calculated as follows: from tricuspid regurgitation: maximum pressure gradient + 10 mmHg; from pulmonary regurgitation: 3 x early diastolic gradient - 2 x late diastolic gradient + 10 mmHg. The systolic pulmonary artery pressures calculated from tricuspid and pulmonary regurgitation were: 42 +/- 16 mmHg and 43 +/- 17 mmHg respectively (r = 0.97) with an estimated standard error of 4.7 mmHg. These results show that the recording of pulmonary regurgitation by continuous wave Doppler allows accurate estimation of pulmonary artery pressures. The calculation by the two methods using tricuspid and pulmonary regurgitant jets increases the reliability of the results and provides a means of internal validation of the Doppler technique.
Raffoul
H
H
Clinique cardiologique et unité INSERM 256, hôpital Broussais, Paris.
Guéret
P
P
Diebold
B
B
Cohen
A
A
Abergel
E
E
Zelinsky
R
R
Ourbak
P
P
Peronneau
P
P
Guérin
F
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D001794:Blood Pressure; D002648:Child; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery; D011665:Pulmonary Valve Insufficiency / Q000503:physiopathology*; D011669:Pulmonary Wedge Pressure; D013599:Systole; D014262:Tricuspid Valve Insufficiency / Q000503:physiopathology*
Intérêt de l'enregistrement du flux d'insuffisance pulmonaire en doppler continu pour l'estimation de la pression artérielle pulmonaire systolique.