Correlation of transthoracic echocardiography and right heart catheterization in pregnancy.
OBJECTIVE
To correlate estimated pulmonary artery pressures (PAP) by echocardiography with right heart catheterization (RHC) measurements and to correlate estimated left ventricular ejection fraction (EF) by echocardiography with cardiac output (CO) measurements by RHC.


METHODS
All women who had echocardiography at a single institution during a 6-year period and underwent RHC during pregnancy were included. Echocardiography estimates of right ventricular systolic pressure (RVSP) and EF were correlated with measured RHC PAP and CO, respectively.


RESULTS
Eighteen patients underwent 21 RHCs, 10 antepartum at the catheterization laboratory and the remaining 11 intrapartum, performed with the use of a pulmonary artery catheter placed prior to the onset or induction of labor. Correlation between RVSP and PAP was good (rho=0.79, P<0.0001); nonetheless, in 30% of cases RHC eliminated the concern for pulmonary hypertension (PHTN). There was minimal correlation between EF and CO.


CONCLUSIONS
Despite good statistical correlation between echocardiography and RHC for determining pulmonary artery pressure, RHC should be considered for major decisions such as pregnancy interruption or preterm delivery given the proportion of cases where concern for PHTN was excluded by RHC. EF provides a poor proxy for CO.
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University, NY, New York, USA. bwylie@partners.org
Blair J
BJ
Wylie
Kelly C
KC
Epps
Sreedhar
S
Gaddipati
Carol A
CA
Waksmonski
D000328:Adult; D006328:Cardiac Catheterization; D004452:Echocardiography; D005260:Female; D006325:Heart Atria; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011669:Pulmonary Wedge Pressure / Q000502:physiology*; D013318:Stroke Volume / Q000502:physiology*