[The prediction of pulmonary artery systolic pressure and vascular resistance by using tricuspid annular tissue Doppler imaging].
OBJECTIVE
This study was planned to determine pulmonary artery pressure and pulmonary vascular resistance by using tricuspid annular tissue Doppler imaging in patients with valvular and congenital heart disease.


METHODS
The study group consisted of patients with valvular and congenital heart disease (n=28). Healthy volunteers (n=10) were included into the control group. Systolic (Sm), early (Em) and late diastolic velocity (Am), isovolumetric relaxation time (IVRTm) were measured from tricuspid annulus by tissue Doppler imaging. Patients of the study group underwent cardiac catheterization and right atrial mean pressure, right ventricle and pulmonary artery systolic- diastolic pressures (PASP and PADP), and pulmonary capillary wedge pressure (PVR, dyn/s/cm-5) were obtained.


RESULTS
There were no significant differences between the groups according to age, gender, left and right ventricle ejection fraction, tricuspid annular Sm, Em and Am velocities and velocity- time integrales (p>0.05). IVRTm was increased in the study group (73.75+/-3.1 ms, p<0.05). For Sm velocities of 11 cm/sec, prediction of PASP >/=30 mmHg was calculated with specificity of 57%, sensitivity of 93%, positive predictive value of 88%, negative predictive value of 68% and accuracy of 75%. For Sm velocities - time integral value of 2.7 cm/sec, prediction of the PVR >/=65 dyn/s/cm-5 was estimated with sensitivity of 88%, specificity of 36%, positive predictive value of 68%, negative predictive value of 66% and accuracy of 68 %.


CONCLUSIONS
Pulmonary artery pressure and pulmonary vascular resistance in patients with valvular and congenital heart disease can be predicted by using the Sm wave parameters detected with tricuspid annular tissue Doppler imaging.
Bolca
Osman
O
Dr.Siyami Ersek Torax and Cardiovascular Surgery Center, Haydarpaşa, Istanbul, Turkey. Bolca@superonline.com
Hobikoğlu
Gültekin
G
Norgaz
Tuğrul
T
Asiltürk
Recep
R
Unal
Sennur
S
Gürkan
Ufuk
U
Narin
Ahmet
A
D018619:Echocardiography, Doppler, Pulsed / Q000592:standards*; D004562:Electrocardiography; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006334:Heart Function Tests / Q000592:standards; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011651:Pulmonary Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011669:Pulmonary Wedge Pressure; D012680:Sensitivity and Specificity; D013599:Systole; D014261:Tricuspid Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology; D014655:Vascular Resistance; D016278:Ventricular Function, Right