Obtaining accurate hemodynamics from echocardiography: achieving independence from right heart catheterization.
OBJECTIVE
Accurate noninvasive evaluation of right heart hemodynamics is an essential component of the comprehensive cardiac examination. We aim to highlight recent advances in echocardiography allowing integration of measurements to obtain diagnostic accuracy.


RESULTS
Reports have advocated different imaging methods to describe right ventricular function and pulmonary artery pressure. Recent review articles provide comprehensive resources for the physician or technologist, and other articles compare echocardiography techniques, including strain imaging and three-dimensional echocardiography. We discuss the descriptions of the accuracy of Doppler echocardiography in comparison with cardiac catheterization.


CONCLUSIONS
Several measurements should be taken together for an accurate interpretation of right heart hemodynamics. We advocate the measurement of the tricuspid regurgitation gradient, pulmonary regurgitation gradient, pulmonary artery stroke distance (velocity time integral; VTI), evaluation of right ventricular function, and right atrial pressure.
Ristow
Bryan
B
California Pacific Medical Center, San Francisco, California, USA. ristowb@sutterhealth.org
Schiller
Nelson B
NB
D001794:Blood Pressure / Q000502:physiology; D006328:Cardiac Catheterization; D004452:Echocardiography / Q000379:methods; D015150:Echocardiography, Doppler; D006321:Heart / Q000502:physiology*; D006439:Hemodynamics; D006801:Humans; D011651:Pulmonary Artery / Q000502:physiology