title: Measurement of pulmonary arterial elastance in patients with systolic heart failure using Doppler echocardiography.
abstract: OBJECTIVE
  A reliable and easy-to-perform method for measuring right ventricular (RV) afterload is desirable when scheduling patients with systolic heart failure to undergo heart transplantation. The present study aimed to investigate the accuracy of echocardiographically-derived pulmonary arterial elastance as a measurement of pulmonary vascular resistance by comparing it with invasive measures.
  
  
  METHODS
  Thirty-one patients with moderate to severe systolic heart failure, including 22 (71%) male patients, with a mean age of 41.16 ± 15.9 years were enrolled in the study. Right heart catheterization and comprehensive echocardiography during the first hour after completion of cardiac catheterization were performed in all the patients. The pulmonary artery elastance was estimated using the ratio of end-systolic pressure (Pes) over the stroke volume (SV) by both cardiac catheterization [Ea (PV)-C] and echocardiography [Ea (PV)-E].
  
  
  RESULTS
  The mean Ea (PV)-C and Ea (PV)-E were estimated to be 0.73 ± 0.49 mm Hg/mL and 0.67 ± 0.44 mm Hg/mL, respectively. There was a significant relation between Ea (PV)-E and Ea (PV)-C (r=0.897, p<0.001). Agreement between echocardiography and catheterization methods for estimating Ea (PV), investigated by the Bland-Altman method, showed a mean bias of -0.06, with 95% limits of agreement from -0.36 mm Hg/mL to 0.48 mm Hg/mL.
  
  
  CONCLUSIONS
  Doppler echocardiography is an easy, non-invasive, and inexpensive method for measuring pulmonary arterial elastance, which provides accurate and reliable estimation of RV afterload in patients with systolic heart failure.
authors.affiliation: Department of Heart Failure and Transplantation, Iran University of Medical Science; Tehran-Iran. m_eszadeh@yahoo.com.
authors.forename: Sepideh
authors.initials: S
authors.lastname: Taghavi
authors.forename: Maryam
authors.initials: M
authors.lastname: Esmaeilzadeh
authors.forename: Ahmad
authors.initials: A
authors.lastname: Amin
authors.forename: Nasim
authors.initials: N
authors.lastname: Naderi
authors.forename: Hooman Bakhshandeh
authors.initials: HB
authors.lastname: Abkenar
authors.forename: Majid
authors.initials: M
authors.lastname: Maleki
authors.forename: Mitra
authors.initials: M
authors.lastname: Chitsazan
mesh_terms: D000328:Adult; D006328:Cardiac Catheterization; D015150:Echocardiography, Doppler; D005260:Female; D054143:Heart Failure, Systolic / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D011651:Pulmonary Artery / Q000503:physiopathology*; D011669:Pulmonary Wedge Pressure; D012720:Severity of Illness Index; D014655:Vascular Resistance