title: [Improvement in the measurement technique of pulmonary artery pressure by Doppler echocardiography with contrast in chronic obstructive pulmonary disease].
abstract: OBJECTIVE
  To evaluate the benefit of contrast echocardiography in the assessment of systolic pulmonary artery pressure (PAPs).
  
  
  METHODS
  Compare standard reference (Doppler-echocardiography) with contrast.
  
  
  METHODS
  Echocardiography department.
  
  
  METHODS
  Ambulatory chronic obstructive patient disease (COPD).
  
  
  METHODS
  Continuous wave Doppler spectral signal of tricuspid regurgitation (TR) was evaluated before and after intravenous injection of a galactose-based intravenous echo-enhancing agent. A four patterns scale classified the quality of the TR signal: 0=absent regurgitation; 1=protosystolic signal not allowing the recognition of peak velocity; 2=non-homogenous signal intensity, albeit allowing the measurement of maximal velocity; and 3=uniform pansystolic velocity signal. PAPs was estimated adding 10 mm Hg to the transtricuspid gradient, calculated from the TR peak velocity.
  
  
  RESULTS
  PAPs was only calculated reliably in 20 (49%) patients before the administration of contrast. Seventeen patients were classified as pattern 2, and three as pattern 3 on the scale of the TR quality signal. After contrast 41 (95%) patients showed a reliable TR signal. Two were classified as pattern 1, 11 as pattern 2 and 28 as pattern 3 on the scale of the TR quality signal. In the 20 patients in whom PAPs was estimated before contrast, a significant increase in PAPs values occurred after contrast, 44±10 mm Hg vs. 56±15 mm Hg (p<0.01).
  
  
  CONCLUSIONS
  The use of an echocardiography contrast agent increases the number of COPD patients in whom PAPs can be estimated non-invasively and may avoid underestimation of the PAP value.
authors.affiliation: Servicio de Medicina Intensiva, Hospital de Sant Pau, Barcelona, España. furones@hotmail.com
authors.forename: B
authors.initials: B
authors.lastname: Cabello
authors.forename: X
authors.initials: X
authors.lastname: Borrás
authors.forename: F
authors.initials: F
authors.lastname: Carreras
authors.forename: B
authors.initials: B
authors.lastname: Thomas
authors.forename: R
authors.initials: R
authors.lastname: Leta
authors.forename: G
authors.initials: G
authors.lastname: Pons-Lladó
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000379:methods*; D003287:Contrast Media; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides; D011651:Pulmonary Artery / Q000502:physiology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D012680:Sensitivity and Specificity; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging* / Q000503:physiopathology
chemical_list: D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508