Open AccessAccuracy of echocardiographic estimations of right heart pressures in adult heart transplant recipients
Author(s) -
Sridharan Aadhavi,
Dehn Monica M.,
Cooper Craig,
Madineedi Vidya S.,
Ordway Linda J.,
DeNofrio David,
Patel Ayan R.
Publication year - 2022
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.23835
Subject(s) - medicine , cardiology , pulmonary artery , heart transplantation , right heart catheterization , hemodynamics , limits of agreement , cardiac catheterization , population , blood pressure , pulmonary hypertension , right heart , correlation , heart failure , nuclear medicine , geometry , mathematics , environmental health
Abstract Background Accurate assessment of right atrial pressure (RAP) and pulmonary artery systolic pressure (PASP) is critical in the management of heart transplant recipients. The accuracy of echocardiography in estimating these pressures has been debated. Objective To assess the correlation and agreement between echocardiographic estimations of right heart pressures with those of respective invasive hemodynamic measurements by right heart catheterization (RHC) in adult heart transplant recipients. Methods This is a prospective evaluation of 84 unique measurements from heart transplant recipients who underwent RHC followed by standard echocardiographic evaluation within 159 ± 64 min with no intervening medication changes. The relationship between noninvasive pressure estimations and invasive hemodynamic measurements was examined. Results Mean RAP was 7 ± 5 mmHg and mean PASP was 33 ± 8 mmHg by RHC. There was no significant correlation between echocardiographic estimation of RAP and invasive RAP (Spearman's rho = −0.05, p = .7), and no significant agreement between these two variables (weighted kappa = −0.1). There was a modest correlation between echocardiographic estimation of PASP and invasive PASP ( r = .39, p = .002). Bland‐Altman analysis showed a mean bias of 2.1 ± 9 mmHg (limits of agreement = −15 to 20 mmHg). Conclusion In heart transplant recipients, there is no significant correlation or agreement between echocardiographic RAP estimation and invasively determined RAP. Noninvasive PASP estimation correlates significantly but modestly with invasively measured PASP. Further refinement of echocardiographic methods for assessment of RAP is warranted in this unique patient population.