title: Mean Pulmonary Artery Pressure Using Echocardiography in Chronic Thromboembolic Pulmonary Hypertension.
abstract: BACKGROUND
  Mean pulmonary arterial pressure (MPAP) is an important pulmonary hemodynamic parameter used in the management of patients with chronic thromboembolic pulmonary hypertension (CTEPH). We compared echocardiography-derived estimates of MPAP with right heart catheterization (RHC) to identify reliable noninvasive methods of estimating MPAP-derived RHC (MPAPRHC) in these patients.
  
  
  RESULTS
  Echocardiography and RHC were performed in 56 patients with CTEPH (60.5±12.0 years; 44 females). We measured the tricuspid regurgitation (TR) pressure gradient (TRPG) using echocardiography. The mean systolic right ventricular (RV)-right atrial (RA) gradient was calculated by tracing the TR time velocity flow. Systolic and mean pulmonary artery pressures (SPAPTRand MPAPTR) estimated from TRPG and mean systolic RV-RA gradient were calculated by adding RA pressure based on the inferior vena cava. MPAPChemlawas calculated using Chemla's formula: 0.61×SPAPTR+2 mmHg. MPAPRHCand pulmonary vascular resistance were 35.9±11.3 mmHg and 6.6±3.6 Wood units, respectively. The mean difference from MPAPRHCand limits of agreement were -1.5 mmHg and -19.6 to 16.5 mmHg for MPAPTR, and -4.6 mmHg and -24.5 to 15.2 mmHg for MPAPChemla. Accuracy within 10 mmHg and 5 mmHg of MPAPRHCwas 80.4% and 46.4% for MPAPTR, and 71.4% and 48.2% for MPAPChemla, respectively.
  
  
  CONCLUSIONS
  MPAPTRand MPAPChemlaare reliable estimates for MPAPRHCin patients with CTEPH. (Circ J 2016; 80: 1259-1264).
authors.affiliation: Department of Respirology, Graduate School of Medicine, Chiba University.
authors.forename: Hajime
authors.initials: H
authors.lastname: Kasai
authors.forename: Akane
authors.initials: A
authors.lastname: Matsumura
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Sugiura
authors.forename: Ayako
authors.initials: A
authors.lastname: Shigeta
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tanabe
authors.forename: Keiko
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Hideki
authors.initials: H
authors.lastname: Miwa
authors.forename: Ryogo
authors.initials: R
authors.lastname: Ema
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Sakao
authors.forename: Koichiro
authors.initials: K
authors.lastname: Tatsumi
mesh_terms: D062186:Arterial Pressure; D006328:Cardiac Catheterization; D002908:Chronic Disease; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000503:physiopathology; D013923:Thromboembolism / Q000000981:diagnostic imaging* / Q000503:physiopathology