Cargando…

Reliability of Doppler echocardiography in the assessment of high pulmonary vascular resistance in patients with severe pulmonary arterial hypertension

BACKGROUND: The objective is to assess whether the squaring of tricuspid regurgitation velocity (TRV) gives an improved estimate of pulmonary vascular resistance (PVR) or is equivalent to the ratio of TRV and time velocity integral of right ventricular outflow tract (TVI(RVOT)) (TRV/TVI(RVOT)) for a...

Descripción completa

Detalles Bibliográficos
Autores principales: Bhyravavajhala, Srinivas, Yerram, Sreekanth, Galla, Raghukishore, Kotapati, Venkata siva krishna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6310071/
https://www.ncbi.nlm.nih.gov/pubmed/30595266
http://dx.doi.org/10.1016/j.ihj.2018.10.031
_version_ 1783383396863442944
author Bhyravavajhala, Srinivas
Yerram, Sreekanth
Galla, Raghukishore
Kotapati, Venkata siva krishna
author_facet Bhyravavajhala, Srinivas
Yerram, Sreekanth
Galla, Raghukishore
Kotapati, Venkata siva krishna
author_sort Bhyravavajhala, Srinivas
collection PubMed
description BACKGROUND: The objective is to assess whether the squaring of tricuspid regurgitation velocity (TRV) gives an improved estimate of pulmonary vascular resistance (PVR) or is equivalent to the ratio of TRV and time velocity integral of right ventricular outflow tract (TVI(RVOT)) (TRV/TVI(RVOT)) for assessing PVR in patients with high PVR values. METHODS: Thirty patients predicted to have PVR >6 WU by Doppler were included in the present study. TRV and TVI(RVOT) were measured by echo Doppler. TRV/TVI(RVOT) and TRV(2)/TVI(RVOT) were calculated. PVR(CATH) was estimated within 2 h of Doppler study. Regression equations for calculating PVR from TRV/TVI(RVOT) (PVR(ECHO1)) and TRV(2)/TVI(RVOT) (PVR(ECHO2)) were developed. Bland–Altman analysis for agreement between PVR(CATH) and PVR(ECHO1), PVR(ECHO2) was carried out. RESULTS: The mean value of PVR(CATH) was found to be 15.08 ± 7.03 WU. The calculated values of PVR(ECHO1) and PVR(ECHO2) were found to be 15.08 ± 6.34 WU and 15.05 ± 6.08 WU, respectively. The linear regression analysis carried out for PVR(CATH) and TRV/TVI(RVOT) showed good correlation (R = 0.84). Bland–Altman analysis showed excellent agreement between the two Doppler methods and invasive PVR with negligible bias. CONCLUSION: Noninvasive estimation of PVR by Doppler is reliable even in patients with high PVR (>6 WU) and, squaring TRV is not superior to TRV alone.
format Online
Article
Text
id pubmed-6310071
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-63100712019-12-01 Reliability of Doppler echocardiography in the assessment of high pulmonary vascular resistance in patients with severe pulmonary arterial hypertension Bhyravavajhala, Srinivas Yerram, Sreekanth Galla, Raghukishore Kotapati, Venkata siva krishna Indian Heart J Cardiac Imaging BACKGROUND: The objective is to assess whether the squaring of tricuspid regurgitation velocity (TRV) gives an improved estimate of pulmonary vascular resistance (PVR) or is equivalent to the ratio of TRV and time velocity integral of right ventricular outflow tract (TVI(RVOT)) (TRV/TVI(RVOT)) for assessing PVR in patients with high PVR values. METHODS: Thirty patients predicted to have PVR >6 WU by Doppler were included in the present study. TRV and TVI(RVOT) were measured by echo Doppler. TRV/TVI(RVOT) and TRV(2)/TVI(RVOT) were calculated. PVR(CATH) was estimated within 2 h of Doppler study. Regression equations for calculating PVR from TRV/TVI(RVOT) (PVR(ECHO1)) and TRV(2)/TVI(RVOT) (PVR(ECHO2)) were developed. Bland–Altman analysis for agreement between PVR(CATH) and PVR(ECHO1), PVR(ECHO2) was carried out. RESULTS: The mean value of PVR(CATH) was found to be 15.08 ± 7.03 WU. The calculated values of PVR(ECHO1) and PVR(ECHO2) were found to be 15.08 ± 6.34 WU and 15.05 ± 6.08 WU, respectively. The linear regression analysis carried out for PVR(CATH) and TRV/TVI(RVOT) showed good correlation (R = 0.84). Bland–Altman analysis showed excellent agreement between the two Doppler methods and invasive PVR with negligible bias. CONCLUSION: Noninvasive estimation of PVR by Doppler is reliable even in patients with high PVR (>6 WU) and, squaring TRV is not superior to TRV alone. Elsevier 2018-12 2018-11-02 /pmc/articles/PMC6310071/ /pubmed/30595266 http://dx.doi.org/10.1016/j.ihj.2018.10.031 Text en © 2018 Cardiological Society of India. Published by Elsevier B.V. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Cardiac Imaging
Bhyravavajhala, Srinivas
Yerram, Sreekanth
Galla, Raghukishore
Kotapati, Venkata siva krishna
Reliability of Doppler echocardiography in the assessment of high pulmonary vascular resistance in patients with severe pulmonary arterial hypertension
title Reliability of Doppler echocardiography in the assessment of high pulmonary vascular resistance in patients with severe pulmonary arterial hypertension
title_full Reliability of Doppler echocardiography in the assessment of high pulmonary vascular resistance in patients with severe pulmonary arterial hypertension
title_fullStr Reliability of Doppler echocardiography in the assessment of high pulmonary vascular resistance in patients with severe pulmonary arterial hypertension
title_full_unstemmed Reliability of Doppler echocardiography in the assessment of high pulmonary vascular resistance in patients with severe pulmonary arterial hypertension
title_short Reliability of Doppler echocardiography in the assessment of high pulmonary vascular resistance in patients with severe pulmonary arterial hypertension
title_sort reliability of doppler echocardiography in the assessment of high pulmonary vascular resistance in patients with severe pulmonary arterial hypertension
topic Cardiac Imaging
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6310071/
https://www.ncbi.nlm.nih.gov/pubmed/30595266
http://dx.doi.org/10.1016/j.ihj.2018.10.031
work_keys_str_mv AT bhyravavajhalasrinivas reliabilityofdopplerechocardiographyintheassessmentofhighpulmonaryvascularresistanceinpatientswithseverepulmonaryarterialhypertension
AT yerramsreekanth reliabilityofdopplerechocardiographyintheassessmentofhighpulmonaryvascularresistanceinpatientswithseverepulmonaryarterialhypertension
AT gallaraghukishore reliabilityofdopplerechocardiographyintheassessmentofhighpulmonaryvascularresistanceinpatientswithseverepulmonaryarterialhypertension
AT kotapativenkatasivakrishna reliabilityofdopplerechocardiographyintheassessmentofhighpulmonaryvascularresistanceinpatientswithseverepulmonaryarterialhypertension