title: Mean pulmonary artery pressure estimated from systolic and diastolic pulmonary artery pressure in children with congenital heart disease: an invasive study.
abstract: This hemodynamic study documented the accuracy and precision of six empirical formulas relating mean (mPAP), systolic (sPAP), and diastolic (dPAP) pulmonary artery pressures in children with congenital heart disease. Fluid-filled PAPs of 61 children (age, 26 +/- 40 months) were analyzed over an mPAP range of 7 to 74 mmHg. All formulas were accurate (mean bias, -2 to 1 mmHg). The three formulas relying on sPAP and dPAP were dPAP + 1/3 (sPAP - dPAP), dPAP + 0.41 (sPAP - dPAP), and sqrt of (sPAP x dPAP). They were precise (bias standard deviation [SD], 3 mmHg), with approximately 90% of patients exhibiting biases of less than 5 mmHg. The three formulas relying on sPAP alone all assumed that mPAP approached two-thirds of sPAP according to slightly different mathematical equations. They were less precise (bias SD, 5-6 mmHg), with biases greater than 7 mmHg for 10% to 16% patients. Accurate estimates of mPAP were obtained from sPAP alone, and this could be valuable for cross-checking the self-consistency of the pressure database obtained in the echo-Doppler laboratory. For cases that had reliable dPAP estimates available, empirical formulas relying on both sPAP and dPAP were more precise and thus must be preferred.
authors.affiliation: EA4046-Medical Intensive Care Unit, Paris Sud University, Le Kremlin-Bicêtre, France. denis.chemla@bct.ap-hop-paris.fr
authors.forename: Denis
authors.initials: D
authors.lastname: Chemla
authors.forename: Viginie
authors.initials: V
authors.lastname: Lambert
authors.forename: Jean
authors.initials: J
authors.lastname: Losay
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000704:Analysis of Variance; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D003971:Diastole; D005260:Female; D006330:Heart Defects, Congenital / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011651:Pulmonary Artery / Q000502:physiology*; D011669:Pulmonary Wedge Pressure; D012044:Regression Analysis; D012189:Retrospective Studies; D013599:Systole