ABSTRACT
Objective: to evaluate the correlation between Doppler echocardiography [DE] and right heart catheterization [RHC] derived pulmonary artery pressures and to assess the impact of right atrial [RA] pressures on this correlation
Study Design: cross-sectional analytical study
Place and Duration of Study: cardiology Department, Tahir Heart Institute, Chenab Nagar, from June 2013 to December 2014
Methodology: all patients undergoing RHC were included. Relevant data were collected from hospital database. Continuous variables were expressed as the mean and SD or as the median and interquartile range where the distributions were skewed. Pearson correlation coefficient and Bland-Altman method were used to correlate DE derived right ventricular systolic pressure [RVSP] and RHC derived systolic pulmonary artery pressures [sPAP]. Adjusted RVSP was calculated by replacing default value of RA pressure [10 mmHg] with RHC derived mean RA pressure. Receiver operating characteristic curve [ROC] was used to identify the best cut-off value of RVSP in predicting pulmonary hypertension
Results: fifty-one patients completed the study protocol. Mean age of study population was 45.22 +/- 15.25 years with male to female ratio of 1.47:1. Median error was 13 mmHg [7 to 20]. Pearson correlation coefficient [r] between RVSP and sPAP was 0.72. Bland-Altman method of correlation showed bias of +4.43 mmHg with 95% limits of agreement ranging from -34.61 to +43.47. Using ROC curve, the best cut-off value of RVSP was greater than 52 mmHg with accuracy of 75% [sensitivity: 81%, specificity: 69%] in predicting pulmonary hypertension. Adjusted RVSP showed only little improvement in correlation [r = 0.75], adjusted error [13.65 +/- 13.05] and diagnostic accuracy [79%]
Conclusion: doppler echocardiography can frequently overestimate pulmonary artery pressures. Though correctly estimated RA pressure may improve this correlation, yet its contribution is only minimal
ABSTRACT
The study aims to highlight the cultural awareness of teanagers between the privacy of the constants and global variables. It is the findings of the researcher in the study for a doctorate titled "The problems of new media and ways of facing them on a sample of teenagers", you must educate teenagers in various fields, such as awareness of identity, awareness of religion, awareness of the Arabic language of the Koran, awareness of oriental traditions and habits, awareness of expatriate culture and egyptianizing it, awareness of the English language of the age and predict the future, awareness of variables needed to enter the age, awareness of technological Innovations, warning parents, teachers and children of the downsides of technological innovations and make them aware of the technological skills so that they can join the labor market, succeed, marry and live happy. Income is very important [that who does not learn and master the technology skills is considered now backward, illiterate and never learnt, and difficult for him to catch the modern era and entering the labor market]. The researcher considers that the conscious family that guide their children and educate them about constants and prepare them for the modern era. The Upbringing institutions [family, school, media, club and mosque, etc.] must be involved in enlightenment, education and supporting teenagers