Superior estimation of pulmonary artery pressure, using doppler ultrasound of the velocity of tricuspid regurgitation, as compared with the main pulmonary artery velocities

ABSTRACT

Assessment of pulmonary hypertension is of prime importance in clinical cardiology. Two doppler methods for assessing pulmonary artery pressure were compared in 21 patients undergoing routine cardiac catheterisation. The peak velocity of tricuspid valvular regurgitant flow was used to derive the peak pressure difference between right ventricle and right atrium according to the modified Bernoulli equation. The systolic pulmonary artery pressure was derived by adding the right atrial pressure (clinically estimated). Measurements of the main pulmonary artery velocities were also made time to peak velocity and right ventricular ejection time, and the two expressed as a ratio. In 5 patients, no pulmonary velocities could be found. Tricuspid regurgitation-estimated systolic pulmonary artery pressure, time-to-peak velocity, and the ratio time-to-peak velocity/right ventricular ejection time were each correlated with the systolic pulmonary artery pressure measured at catheter, with the following r values 0.96, -0.49, -0.38 respectively. Time-to-peak velocity correlated poorly, but other factors affect this measurement. Tricuspid regurgitation-estimated systolic pulmonary showed an excellent correlation, suggesting the clinical value of the method in patients with triscuspid regurgitation (AU)