title: Usefulness of the Continuous-Wave Doppler-Derived Pulmonary Arterial-Right Ventricular Pressure Gradient Just before Atrial Contraction for the Estimation of Pulmonary Arterial Diastolic and Wedge Pressures.
abstract: In our new echocardiographic method, pulmonary regurgitant velocity immediately before right atrial (RA) contraction is used to estimate pulmonary artery diastolic pressure (PADP) and mean PA wedge pressure (MPAWP). Our aim here was to compare the usefulness of this new method with that of the conventional method, which uses pulmonary regurgitant velocity at end diastole. We studied 55 consecutive patients who underwent echocardiography and right-sided heart catheterization. The pulmonary regurgitant velocities just before RA contraction and at end diastole were measured to obtain echocardiographic estimates of PADP (EPADPpreAand EPADPED, respectively) by adding the pressure gradients to the echocardiographically estimated RA pressure. Compared with EPADPED, EPADPpreAcorrelated better with PADP (r = 0.87) and MPAWP (r = 0.80), and direct fixed biases were detected for EPADPEDbut not for EPADPpreA. The area under the receiver operating characteristic curve distinguishing patients with MPAWP ≥18 mm Hg was greater for EPADPpreA(0.97) than for E/e' (0.94) and E/A (0.83). EPADPpreAis thus useful in estimating PADP and MPAWP in patients with heart disease.
authors.affiliation: Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan.
authors.forename: Michito
authors.initials: M
authors.lastname: Murayama
authors.affiliation: Faculty of Health Sciences, Hokkaido University, Sapporo, Japan. Electronic address: mikami@hs.hokudai.ac.jp.
authors.forename: Taisei
authors.initials: T
authors.lastname: Mikami
authors.affiliation: Faculty of Health Sciences, Hokkaido University, Sapporo, Japan.
authors.forename: Sanae
authors.initials: S
authors.lastname: Kaga
authors.affiliation: Faculty of Health Sciences, Hokkaido University, Sapporo, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Okada
authors.affiliation: Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Takuma
authors.initials: T
authors.lastname: Hioka
authors.affiliation: Faculty of Health Sciences, Hokkaido University, Sapporo, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Masauzi
authors.affiliation: Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nakabachi
authors.affiliation: Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Hisao
authors.initials: H
authors.lastname: Nishino
authors.affiliation: Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Shinobu
authors.initials: S
authors.lastname: Yokoyama
authors.affiliation: Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Nishida
authors.affiliation: Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Iwano
authors.affiliation: Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Mamoru
authors.initials: M
authors.lastname: Sakakibara
authors.affiliation: Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamada
authors.affiliation: Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsutsui
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016275:Atrial Function / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology*; D003971:Diastole; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000502:physiology*; D011669:Pulmonary Wedge Pressure / Q000502:physiology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016276:Ventricular Function / Q000502:physiology*; D055815:Young Adult
keywords: Continuous-wave Doppler echocardiography; Pulmonary arterial diastolic pressure; Pulmonary arterial wedge pressure; Pulmonary regurgitation; Right atrial contraction