Extension of Doppler-derived echocardiographic measures of pulmonary vascular resistance to patients with moderate or severe pulmonary vascular disease.
BACKGROUND
Pulmonary vascular resistance (PVR) is a critical parameter in the assessment and treatment of patients with pulmonary hypertension, regardless of origin. Noninvasive estimation of PVR could be helpful.


METHODS
Consecutive patients with known or suggested pulmonary hypertension referred for cardiac catheterization were evaluated prospectively and the PVR was calculated invasively. Subsequently, the tricuspid regurgitation velocity (TRV), the velocity-time integral (mean of 3 measurements) of the right ventricular outflow tract (VTIm), and the right ventricular outflow tract diameter were recorded noninvasively.


RESULTS
The TRV/VTIm ratio and the TRV/VTIm corrected for the indexed RVOT diameter correlated well with the PVR at catheterization with R(2) = 0.711 and R(2) = 0.731, respectively, including patients with very high values of PVR. A TRV/VTI(RVOT) value of 38 provided a specificity of 100% for a PVR of 8 Woods units.


CONCLUSIONS
Noninvasive estimation is feasible over a broad range of PVR values and could be a useful tool to estimate and longitudinally tracked changes in PVR.
Vlahos
Antonios P
AP
Child Health Department, Pediatric Cardiology Division, University of Ioannina, Ioannina, Greece. anvlahos@uoi.gr
Feinstein
Jeffrey A
JA
Schiller
Nelson B
NB
Silverman
Norman H
NH
D000293:Adolescent; D000328:Adult; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D015150:Echocardiography, Doppler; D005240:Feasibility Studies; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D012720:Severity of Illness Index; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology; D014655:Vascular Resistance