title: Can echocardiographically estimated pulmonary arterial elastance be a non-invasive predictor of pulmonary vascular resistance?
abstract: BACKGROUND
  Measurement of pulmonary vascular resistance (PVR) is essential in evaluating a patient with pulmonary hypertension.
  
  
  METHODS
  Data from right heart catheterization (RHC) and echocardiograms performed within 90 days of each other on 45 non-consecutive adult patients were reviewed in this retrospective study. Patients were recruited using an assortment of strategies to ensure the presence of patients with a wide range of PVR.
  
  
  RESULTS
  The linear regression equation between RHC-derived PVR and echocardiographic pulmonary arterial elastance (PAE) was: PVR = (562.6 × PAE) - 38.9 (R = 0.56, p < 0.0001). An adjustment for echocardiographic PAE was made by multiplying it by hemoglobin (in g/dl) and (right atrial area)(1.5) (in cm(3)). As RHC-derived PVR varies with blood hemoglobin, an adjustment for PVR was made for hemoglobin of 12 g/dl. Visualization of the XY scatter plot of adjusted PVR and adjusted PAE isolated a subset of patients with PVR higher than 8.8 Wood units, where a strong linear relationship existed (adjusted PVR = (0.89 × adjusted PAE) + 137.4, R = 0.89, p = 0.008).
  
  
  CONCLUSIONS
  The correlation coefficient of the regression equation connecting echocardiographic PAE and RHC-derived PVR was moderate. In a subset of patients with very high PVR and after appropriate adjustment, a strong linear relationship existed with an excellent correlation coefficient.
authors.affiliation: Division of Pulmonary and Transplantation Medicine, Department of Medicine, The Methodist Hospital, Houston, TX, USA.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Sinha
authors.affiliation: Division of Cardiology, Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
authors.forename: Srikala
authors.initials: S
authors.lastname: Devabhaktuni
authors.affiliation: Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
authors.forename: Aparna
authors.initials: A
authors.lastname: Kadambi
authors.affiliation: Division of Cardiology, Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
authors.forename: John A
authors.initials: JA
authors.lastname: McClung
authors.affiliation: Division of Cardiology, Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY, USA ; Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
authors.forename: Wilbert S
authors.initials: WS
authors.lastname: Aronow
authors.affiliation: Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
authors.forename: Stuart G
authors.initials: SG
authors.lastname: Lehrman
keywords: echocardiography; pulmonary arterial elastance; pulmonary vascular resistance