title: Pulmonary pressure checked by echocardiography in chagasic patients on the heart transplant waiting list.
abstract: BACKGROUND
  The patients suffering heart failure develop an increase in pulmonary pressure because of a retrograde mechanism. The pulmonary hypertension is a prognostic marker.
  
  
  OBJECTIVE
  The aim of this study is to correlate pulmonary hypertension measured by echocardiogram versus catheterization in pre-heart transplant patients on waiting list.
  
  
  METHODS
  Data from 90 patients of the Clinical Hospital UFMG were collected between 2004 and 2009. All the patients took an echo and catheterization as an integral part of pre-heart transplant. Mean age was 45.5 years old, 68 (75.6%) male. Fourty-two (46.7%) were Chagas' disease patients, 32 (35.6%) presented idiopathic dilated cardiomyopathy, 10 (11.1%) had ischemic cardyomiopathy.
  
  
  RESULTS
  The mean eco-PASP was 45 ± 12mmHg). The mean cat-PASP was 47 ±14mmHg. The eco-PASP-Chagas was 41.7 ±12,5 mmHg and non-Chagas 47.6 ±12.8 mmHg P=0.04. The cat-PASP-Chagas was 46 ±12.1 mmHg and non-Chagas 48.7 ±12.8 mmHg P=0.43. Eight patients had cat-PASP>60. The correlation between eco-PASP and cat-PASP in Chagas' patients was r=0.45; P=0.008 and in the non-Chagas was r=0.66; P<0.001. The eco-PASP-Chagas>32,5mmHg has a sensitivity of 79% and specificity of 75% to diagnose PH, with an area under the curve of 0.819. The eco-PASP-non-Chagas>35.5 mmHg has a sensitivity of 82% and a specificity of 70% to diagnose PH, with an area under the curve of 0.776.
  
  
  CONCLUSIONS
  There is a good correlation between eco-PASP and cat-PASP (r=0.54) in pre-heart transplant patients. The eco-PASP was lower in the Chagas' group. The echocardiogram is an important method to diagnosis and control pulmonary pressure in pre-heart transplant, specifically in Chagas' patients. The catheterization is still important to evaluate pulmonary reactivity during vasodilation test.
authors: Hospital das Clínicas, UFMG. clgelape@uai.com.br
authors: Cláudio Léo
authors: CL
authors: Gelape
authors: Maria do Carmo Pereira
authors: Mdo C
authors: Nunes
authors: Renato
authors: R
authors: Bráulio
authors: Paulo Henrique
authors: PH
authors: Nogueira
authors: Silvio Amadeu de
authors: SA
authors: Andrade
authors: Paula Athayde Braga
authors: PA
authors: Machado
authors: Piero Menoti
authors: PM
authors: Orlandi
authors: Maria da Consolação Vieira
authors: Mda C
authors: Moreira
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization / Q000379:methods*; D014355:Chagas Disease / Q000000981:diagnostic imaging*; D015150:Echocardiography, Doppler / Q000379:methods*; D004812:Epidemiologic Methods; D005260:Female; D016027:Heart Transplantation; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011651:Pulmonary Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D014850:Waiting Lists; D055815:Young Adult