title: Accuracy of Doppler-echocardiographic mean pulmonary artery pressure for diagnosis of pulmonary hypertension.
abstract: BACKGROUND
  The validity of Doppler echocardiographic (DE) measurement of systolic pulmonary artery pressure (sPAP) has been questioned. Recent studies suggest that mean pulmonary artery pressure (mPAP) might reflect more accurately the invasive pressures.
  
  
  RESULTS
  241 patients were prospectively studied to evaluate the diagnostic accuracy of mPAP for the diagnosis of PH. Right heart catheterization (RHC) and DE were performed in 164 patients mainly for preoperative evaluation of heart valve dysfunction. The correlation between DE and RHC was better when mPAP (r=0.93) and not sPAP (r=0.81) was assessed. Bland-Altman analysis revealed a smaller variation of mPAP than sPAP. The following ROC analysis identified that a mPAP≥25.5 mmHg is useful for the diagnosis of PH. This value was validated in an independent cohort of patients (n=50) with the suspicion of chronic-thromboembolic pulmonary hypertension. The calculated diagnostic accuracy was 98%, based on excellent sensitivity of 98% and specificity of 100%. The corresponding positive and negative predictive values were 100%, respectively 88%.
  
  
  CONCLUSIONS
  mPAP has been found to be highly accurate for the initial diagnosis of PH. A cut-off value of 25.5 mmHg might be helpful to avoid unnecessary RHC and select patients in whom RHC might be beneficial.
authors.affiliation: Department of Internal Medicine III, University of Cologne, Cologne, Germany. Fikret.Er@uk-koeln.de
authors.forename: Fikret
authors.initials: F
authors.lastname: Er
authors.forename: Stefan
authors.initials: S
authors.lastname: Ederer
authors.forename: Amir M
authors.initials: AM
authors.lastname: Nia
authors.forename: Evren
authors.initials: E
authors.lastname: Caglayan
authors.forename: Kristina M
authors.initials: KM
authors.lastname: Dahlem
authors.forename: Nasser
authors.initials: N
authors.lastname: Semmo
authors.forename: Natig
authors.initials: N
authors.lastname: Gassanov
mesh_terms: D000368:Aged; D015331:Cohort Studies; D004452:Echocardiography / Q000379:methods; D005260:Female; D006349:Heart Valve Diseases / Q000473:pathology; D006351:Heart Valves / Q000473:pathology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000378:metabolism*; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000473:pathology*; D012372:ROC Curve; D015203:Reproducibility of Results