title: [Heart auscultatory assessment of pulmonary artery systolic pressure].
abstract: BACKGROUND
  The clinical assessment of pulmonary artery systolic pressure (PASP) by means of heart auscultation may be comparable to the measures obtained by Doppler echocardiography.
  
  
  OBJECTIVE
  To compare PASP estimated by heart auscultation and echocardiography.
  
  
  METHODS
  Thirty consecutive patients aged 70 ± 16 years (68% women) were evaluated prospectively, all of whom had an echocardiogram requested by their attending physician. Echocardiographic evaluation of PASP was made by tricuspid regurgitation velocity plus right a trial pressure estimate. Two trained clinicians, blinded for the clinical history and rest of physical examination, auscultated the patients. PASP was estimated from the auscultatory intensity of the pulmonary component in comparison to the aortic component of the second heart sound and its propagation towards the apex, in accordance to a pre-established algorithm. Correlation between auscultatory and echocardiographic measures of PASP was made by Pearson test. Variability between both methods and among observers was evaluated with Bland-Altman analysis.
  
  
  RESULTS
  Fifty two per cent of patients were hypertensive and 20% diabetic. Admission diagnoses were heart failure in 50% of cases, exacerbation of chronic obstructive pulmonary disease in 20%, pulmonary thromboembolism in 10% and other clinical entities in 20%. A significant correlation was found between auscultatory and echocardiographic estimation of PASP (r = 0.64, p = 0, 01). Bland-Altman analysis showed a mean difference between both determinations of 7.6 ± 7.6 mmHg. Bland-Altman analysis between both operators showed an average difference of 5.4 ± 8.4 mm Hg.
  
  
  CONCLUSIONS
  Heart auscultatory evaluation allows a precise and reproducible estimation of PASP and compares favorably with echocardiographic assessment.
authors.affiliation: Departmento de Enfermedes Cardiovasculares, Pontificia Universidad Católica de Chile, Chile.
authors.forename: Paul
authors.initials: P
authors.lastname: McNab
authors.forename: Pablo
authors.initials: P
authors.lastname: Castro
authors.forename: Hugo
authors.initials: H
authors.lastname: Verdejo
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Martínez
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D015150:Echocardiography, Doppler / Q000379:methods; D004812:Epidemiologic Methods; D005260:Female; D006326:Heart Auscultation / Q000379:methods*; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D029424:Pulmonary Disease, Chronic Obstructive / Q000000981:diagnostic imaging / Q000503:physiopathology; D013599:Systole / Q000502:physiology