ABSTRACT
Pulmonary artery wedge pressure is an important determinant in the clinical management and prognostic evaluation of patients with various heart diseases. To confirm the utility of continuous wave Doppler echocardiography in assessing pulmonary artery wedge pressure in patients with mitral regurgitation, 59 patients underwent simultaneous determination of the pulmonary artery wedge pressure by Doppler and left and right cardiac catheterization. Doppler-derived pulmonary artery wedge pressure was determined using the estimated left ventricular systolic pressure minus the measured mitral regurgitant gradient. A high correlation [r = 0.964, SEE = 2.1 mmHg] and a close agreement were observed between Doppler and catheter-determined pulmonary artery wedge pressures in patients with normal pulmonary vascular resistance. However, there was a lower correlation [r = 0.596, SEE = 4.9 mmHg] and an unacceptable discordance in pulmonary artery wedge pressures between the two techniques in patients with elevated pulmonary vascular resistance. These data indicate that continuous wave Doppler echocardiography is a useful and accurate technique which nevertheless has some limitations in the non-invasive assessment of pulmonary artery wedge pressure
Subject(s)
Humans , /standardsABSTRACT
Determination of right-side intracardiac pressures is important in clinical decision-making, evaluation of therapeutic interventions and postoperative follow-up in many cardiac diseases. To compare two methods [transseptal gradient and transtricuspid gradient] respectively with invasive measurements in the same patient, continuous wave Doppler-echo and left and right catheterization were performed in 27 patients with congenital ventricular septal defects and associated tricuspid regurgitation. Right ventricular and pulmonary artery systolic pressures were respectively estimated by subtracting transseptal peak gradient from systolic blood pressure or by maximal tricuspid regurgitant gradient plus assumed right atrial pressure. There were high correlations [r=0.944, Standard estimate error [SEE]=4.9 mmHg and r=0.932, SEE=5.6 mmHg] between transseptal method and invasive results, and excellent correlations [r=0.981, SEE=2.6 mmHg and r=0.983, SEE=2.8 mmHg] were also observed between transtricuspid method and catheter measurements. The present report further demonstrated that the Doppler technique was a reliable and accurate method in assessment of right ventricular and pulmonary artery systolic pressures, and the different Doppler method possessed its practical value and offered the alternative way in particular clinical status