New approaches to noninvasive assessment of pulmonary artery pressure.
Direct measurement of pulmonary artery pressure (PAP) was performed in 36 patients; right ventricular (RV) isovolumic relaxation time (IRT) and RV systolic output acceleration time (AcT) values were assessed by pulsed Doppler and 2-M echocardiography. There was a fairly good correlation between RV IRT and systolic PAP (r = 0.898; SEE = 7.8 mmHg) and a somewhat weaker one between RV AcT and systolic PAP (r = -0.880; SEE = 8.37 mmHg). Correlation coefficients were the highest between systolic PAP and the [formula: see text] (r = 0.972; SEE = 4.14), and also between mean PAP and the 10-RV AcT/100 predictor: y = 158x + 6.7 (r = 0.951; SEE = 3.48 mmHg). With +/- 5 mmHg deviations, systolic PAP measurements were accurate in 78% and those of mean PAP in 98% of the patients. The double-blind assessment of the reproducibility of the suggested noninvasive PAP measurement was performed in 18 subsequent patients; the interstudy variability of the measurement was 0.88 +/- 0.94 mmHg and 1.22 +/- 1.23 mmHg (p > 0.05), whereas interobserver variability was 1.90 +/- 1.70 mmHg and 1.67 +/- 1.63 mmHg, respectively (p > 0.05). Thus, a combined use of the most informative intervals of RV cycle--IRT and AcT--contributes to the accuracy of noninvasive PAP measurement.
Mirrakhimov
M M
MM
Department of Valvular Heart Disease and Heart Failure, Kirghiz Institute of Cardiology, Bishkek, Kyrgyzstan.
Tenenbaum
A M
AM
Moldotashev
I K
IK
Niazova
Z A
ZA
Zlatkovsky
M L
ML
D000293:Adolescent; D000328:Adult; D001795:Blood Pressure Determination / Q000379:methods*; D006328:Cardiac Catheterization; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D011669:Pulmonary Wedge Pressure; D015203:Reproducibility of Results; D016276:Ventricular Function / Q000502:physiology*; D017725:Ventricular Pressure