Noninvasive measurement of systemic vascular resistance using Doppler echocardiography.
BACKGROUND
Systemic vascular resistance (SVR) is an integral therapeutic component of patients with heart failure and shock. We hypothesized that the ratio of the peak mitral regurgitant velocity (MRV) (m/s) to left ventricular outflow time-velocity integral (TVI(LVOT)) (cm) by Doppler would provide a noninvasive correlate of SVR.


METHODS
SVR was correlated to MRV/TVI(LVOT) in 33 patients undergoing right heart catheterization. Receiver operating characteristic curves were generated to determine the best-balanced sensitivity and specificity to identify SVR > 14 Wood units (WU) and <10 WU.


RESULTS
MRV/TVI(LVOT) correlated well with SVR (r = 0.842, 95% confidence interval 0.7-0.92, P <.001, Y = 0.459 + 49.397*X). By receiver operating characteristics, MRV/TVI(LVOT) > 0.27 had a 70% sensitivity and a 77% specificity to identify SVR > 14 WU. MRV/TVI(LVOT) < 0.2 had a 92% sensitivity and a 88% specificity to identify SVR < 10 WU.


CONCLUSIONS
Doppler echocardiography provides a reliable noninvasive assessment of SVR.
Abbas
Amr E
AE
William Beaumont Hospital, Royal Oak, MI 48073, USA. aabbas@beaumont.edu
Fortuin
F David
FD
Patel
Bhavesh
B
Moreno
Carlos A
CA
Schiller
Nelson B
NB
Lester
Steven J
SJ
D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity / Q000502:physiology; D006328:Cardiac Catheterization; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014655:Vascular Resistance / Q000502:physiology*