Diagnostic value of pulsed Doppler echocardiography in acute pulmonary thromboembolism--comparison with pulmonary angiography and pulmonary artery pressure.
The ratio of acceleration time to right ventricular ejection time (AcT/RVET) can be derived from the blood flow patterns recorded by pulsed wave Doppler echocardiography. In chronic cor pulmonale, AcT/RVET negatively correlates with pulmonary artery pressure (PAP). The present study evaluated the diagnostic value of AcT/RVET by comparing this variable with indices derived from pulmonary angiography (PAG) and PAP in 16 patients with acute pulmonary thromboembolism (APTE). AcT/RVET, PAP, and PAG severity indices (Miller index (MI) and UPET objective angiographic index (UI)) were measured during the acute phase on admission and the chronic phase after treatment. In the acute phase, AcT/RVET correlated with mean PAP (mPAP) (r=-0.68, p<0.05) and total pulmonary resistance (TPR) (r=-0.66, p<0.05), but not with MI or UI. During the chronic phase, AcT/RVET did not correlate with mPAP or TPR, but with both PAG indices (MI: r=0.76, p<0.05, UI: r=0.65, p<0.05). Before treatment of the APTE, AcT/RVET remained at low levels and could be used as an index of pulmonary hypertension. After treatment, however, following improvement of PAP, AcT/RVET was not useful for evaluating PAP, but might serve as an index for evaluating the volume of residual thrombi.
Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
T
T
Yoshinaga
S
S
Ikeda
E
E
Nishimura
K
K
Shioguchi
M
M
Shikuwa
Y
Y
Miyahara
S
S
Kohno
D000208:Acute Disease; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D006328:Cardiac Catheterization; D002302:Cardiac Output; D017023:Coronary Angiography / Q000592:standards; D018619:Echocardiography, Doppler, Pulsed / Q000592:standards*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000502:physiology; D011655:Pulmonary Embolism / Q000175:diagnosis*