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Limitations and Strengths of Doppler/Echo Pulmonary Artery Systolic Pressure–Right Heart Catheterization Correlations: A Systematic Literature Review
Author(s) -
Finkelhor Robert S.,
Lewis Steven A.,
Pillai Dilip
Publication year - 2015
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.12594
Subject(s) - medicine , right heart catheterization , cardiology , pulmonary artery , right heart , pulmonary hypertension
Aims Because many recent studies have questioned the accuracy of Doppler echocardiography (D) in determining pulmonary artery systolic pressure ( PASP ), we performed a detailed literature analysis attempting add clarity. Methods and Results Studies through 2011 comparing D and right heart catheterization ( RHC ) PASP , with at least 25 studied patients and reporting correlation coefficients (r) were identified. Patient demographics, study characteristics, the percent of patients studied for left or right heart pathologies, and study biases were determined. After adjusting for differing study sizes, each study's r value was used as a single datapoint and dichotomized above or below the entire cohort's mean values. From 32 studies 2604 D‐ RHC parings were reported. Their overall weighted r was 0.68 ± 0.19. Poorer correlations were found for right heart pathologies compared to left heart pathologies (r = 0.58 vs. 0.84, P < 0.001) and for normal PASP patients in a study compared to abnormal PASP patients (r = 0.55 vs. 0.82, P < 0.001). Studies with predominately right heart pathology had a significantly greater D‐ RHC time difference, fewer successful D determinations, a greater percentage of normal PASP s on RHC , and more between‐method differences >10 mmHg. Metaregression analyses indicated that both right heart pathology predominance and a greater percent of normal PASP s on RHC remained associated with poorer correlations. Conclusions D PASP ‐ RHC correlations were high and between‐method differences less in patients with left heart pathology but were poorer for right heart diseases and studies with proportionately more normal PASP s on RHC for which further study is needed.