Quantification of pulmonary artery wedge pressure by simultaneous doppler echocardiography and catheterization

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