Noninvasive differentiation of pulmonary arterial hypertension and pulmonary venous hypertension by echocardiography / 中华超声影像学杂志

ABSTRACT

Objective To determine whether pulmonary arterial hypertension(PAH) and pulmonary venous hypertension (PVH) can be differentiated noninvasively by echocardiography. Methods Fifty-six patients with pulmonary arterial systolic pressure(PASP) ≥40 mmHg by echocardiography were involved,and cardiac catheterization performed within 7 days of each other. Based on left ventricular end-diastolic pressure or pulmonary capillary wedge pressure(PCWP) ,30 patients were classified as PAH group and 26 patients as PVH group. The early(E) and late(A) diastolic mitral inflow velocities,E/A ratios,deceleration time(DT),early dastlic mitrial annular velocity(E') and E/E' ratios were measured by conventional and Doppler tissue imaging echocardiography in the two groups. Results Compared with PVH group,the PAH group had significantly higher A,DT,PASP and E',and significantly lower E,E/A ratio and E/E' ratio (P < 0. 01 or P <0. 001). E/E' and E/A ratio was optimal indexes for differentiation of PAH and PVH,the area under receiver operating characteristic curve was 97% and 91 %, respectively. Optimal cutoff for diagnosing PVH was E/E'>9.2 (sensitivity 95%, specificity 97%) and E/A> 1. 7 (sensitivity 75%,specificity 92%). Conclusions PAH and PVH imaging can be reliably differentiated by echocardiography.