title: A simple echocardiographic score for the diagnosis of pulmonary vascular disease in heart failure.
abstract: OBJECTIVE
  A simple echocardiographic score was designed for diagnosing precapillary vs postcapillary pulmonary hypertension and for discriminating between isolated postcapillary pulmonary hypertension (Ipc-PH) and combined precapillary and postcapillary pulmonary hypertension (Cpc-PH).
  
  
  METHODS
  The score comprised 7 points (2 for E/e' ratio ≤10, 2 for a dilated non-collapsible inferior vena cava, 1 for a left ventricular eccentricity index ≥1.2, 1 for a right-to-left heart chamber dimension ratio >1 and 1 for the right ventricle forming the heart apex) and was applied to 230 consecutive patients referred for evaluation of pulmonary hypertension.
  
  
  RESULTS
  Precapillary pulmonary hypertension and postcapillary pulmonary hypertension were diagnosed in 160 and 70 patients, respectively. In the latter, Ipc-PH was found in 51 and Cpc-PH in 19. The echo score was higher in precapillary vs postcapillary pulmonary hypertension patients (4.2 ± 1.7 vs 1.6 ± 1.7, P < 0.001) and in patients with Cpc-PH vs Ipc-PH (2.7 ± 2.1 vs 1.2 ± 1.3, P = 0.001). The sensitivity and specificity of the echo score at least 2 for precapillary pulmonary hypertension were 99 and 54%, respectively (area under the curve 0.85). In patients with postcapillary pulmonary hypertension, the sensitivity and specificity of the echo score at least 2 for Cpc-PH were 63 and 82% (area under the curve 0.73).
  
  
  CONCLUSIONS
  A simple echocardiographic score helps in the differential diagnosis between precapillary and postcapillary pulmonary hypertension, and between Ipc-PH and Cpc-PH.
authors.affiliation: aDepartment of Cardiology, Second University of Naples, Monaldi Hospital, Naples, Italy bDepartment of Cardiology, Moliére-Longchamp Hospital, Université Libre de Bruxelles, Belgium cDepartment of Radiology, Monaldi Hospital, Naples dDepartment of Cardiology and Cardiac Surgery, 'San Giovanni di Dio e Ruggi d'Aragona' University Hospital, Salerno, Italy eDepartment of Cardiology, Erasme University Hospital, Brussels, Belgium.
authors.forename: Michele
authors.initials: M
authors.lastname: D'Alto
authors.forename: Emanuele
authors.initials: E
authors.lastname: Romeo
authors.forename: Paola
authors.initials: P
authors.lastname: Argiento
authors.forename: Adriana
authors.initials: A
authors.lastname: Pavelescu
authors.forename: Antonello
authors.initials: A
authors.lastname: D'Andrea
authors.forename: Giovanni M
authors.initials: GM
authors.lastname: Di Marco
authors.forename: Agostino
authors.initials: A
authors.lastname: Mattera Iacono
authors.forename: Berardo
authors.initials: B
authors.lastname: Sarubbi
authors.forename: Gaetano
authors.initials: G
authors.lastname: Rea
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bossone
authors.forename: Maria G
authors.initials: MG
authors.lastname: Russo
authors.forename: Robert
authors.initials: R
authors.lastname: Naeije
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D006328:Cardiac Catheterization; D003937:Diagnosis, Differential; D015150:Echocardiography, Doppler; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000503:physiopathology*; D011669:Pulmonary Wedge Pressure; D012372:ROC Curve; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000503:physiopathology; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right