title: The strengths and weaknesses of non-invasive parameters obtained by echocardiography and cardiopulmonary exercise testing in comparison with the hemodynamic assessment by the right heart catheterization in patients with pulmonary hypertension.
abstract: OBJECTIVE
  Pulmonary hypertension (PH) diagnosis requires invasive assessment by right heart catheterization (RHC), but screening and monitoring are performed using non-invasive methods: echocardiography and cardiopulmonary exercise testing (CPET). The aim of the study was to assess correlations between the parameters obtained in non-invasive testing and RHC in patients with PH of different etiologies.
  
  
  METHODS
  The study included 53 medical records of PH patients (32 women) aged 29-81 years. We analyzed correlations between RHC (systolic pulmonary artery pressure (sPAP), diastolic pulmonary artery pressure (dPAP), pulmonary vascular resistance (PVR), cardiac output (CO)) and echocardiographic (tricuspid annular plane systolic excursion (TAPSE), sPAP) and CPET parameters (end-tidal oxygen and carbon dioxide pressures (PetO2, PetCO2), ventilation efficiency (VE/VCO2) slope).
  
  
  RESULTS
  Echocardiographic estimation correlated well with RHC measurement of sPAP (r=0.65, P<0.001). TAPSE correlated with PVR assessed with thermodilution method (r=-0.5, P=0.005), dPAP (r=-0.53, P=0.002) and CO (r=0.53, P=0.002). PVR assessed with thermodilution and Fick methods showed positive correlation with PetO2(r=0.74, P<0.001 and r=0.72, P<0.001) and negative correlation with PetCO2(r=-0.59, P=0.004 and r=-0.64, P=0.002) at the anaerobic threshold. VE/VCO2slope correlated with dPAP (r=0.43, P=0.04) and PVR calculated with both methods (r=0.52, P=0.01 and r=0.52, P=0.02).
  
  
  CONCLUSIONS
  Simple cardiac function indicators obtained by commonly used non-invasive methods allow only approximate estimation of the main hemodynamic RHC-derived parameters: sPAP, CO and PVR. Obtained results suggest the relationship between RV dysfunction and ventilation abnormalities in PH patients.
authors.affiliation: Department of Cardiology, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Ptaszyńska-Kopczyńska
authors.affiliation: Students' Scientific Society, Department of Cardiology, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Krentowska
authors.affiliation: Students' Scientific Society, Department of Cardiology, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Emilia
authors.initials: E
authors.lastname: Sawicka
authors.affiliation: Students' Scientific Society, Department of Cardiology, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Skoneczny
authors.affiliation: Department of Cardiology, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Jasiewicz
authors.affiliation: Department of Cardiology, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Knapp
authors.affiliation: Department of Cardiology, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Włodzimierz J
authors.initials: WJ
authors.lastname: Musiał
authors.affiliation: Department of Cardiology, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Bożena
authors.initials: B
authors.lastname: Sobkowicz
authors.affiliation: Department of Cardiology, Medical University of Bialystok, Bialystok, Poland; Department of Community Medicine and Civilization Disease Prevention, Medical University of Bialystok, Bialystok, Poland. Electronic address: fizklin@wp.pl.
authors.forename: Karol A
authors.initials: KA
authors.lastname: Kamiński
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization / Q000379:methods*; D004452:Echocardiography / Q000379:methods*; D005080:Exercise Test / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies
keywords: Cardiopulmonary exercise testing; Echocardiography; Pulmonary artery pressure; Pulmonary hypertension; Right heart catheterization