Noninvasive and invasive evaluation of pulmonary arterial pressure in highlanders.
The purpose of the present study was to evaluate Doppler echocardiography for the detection of pulmonary hypertension in high-altitude inhabitants. In total, 60 (55 male) patients aged 18-71 yrs were recruited from an ECG screening programme applied to 1,430 inhabitants living at an altitude of 2,500-3,600 m in Kyrgyzstan. Of these, 44 met ECG criteria for right ventricular hypertrophy. All underwent Doppler echocardiography followed by a cardiac catheterisation within 7 days of arrival in Bishkek (Kyrgyzstan; altitude 760 m). Pulmonary flow acceleration time and the maximum velocity of tricuspid regurgitation were measured. Sufficient quality tricuspid regurgitant jets were recovered in only 28% of the patients. Therefore, pulmonary artery pressure was estimated from the pulmonary flow acceleration time, which was recovered in 100% of the patients. It was found that 37 (62%) of the patients had pulmonary hypertension on echocardiography. Pulmonary hypertension was confirmed in 29 patients on catheterisation. Pulmonary hypertension was detected with 70% sensitivity and 88% specificity by echocardiography, as compared to 59% sensitivity and 81 % specificity by ECG. The correlation coefficient between echocardiography and catheterisation studies was r(2) = 0.78. It is concluded that a combination of ECG and echocardiography may be useful for screening high-altitude pulmonary hypertension.
Kojonazarov
B K
BK
Institute of Molecular Biology and Medicine, Bishkek, Kyrgyzstan.
Imanov
B Z
BZ
Amatov
T A
TA
Mirrakhimov
M M
MM
Naeije
R
R
Wilkins
M R
MR
Aldashev
A A
AA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000531:Altitude; D001794:Blood Pressure; D015150:Echocardiography, Doppler / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000000981:diagnostic imaging; D007707:Kyrgyzstan; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity