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Correlation between Pulmonary Artery Pressure Measured by Echocardiography and Right Heart Catheterization in Patients with Rheumatic Mitral Valve Stenosis (A Prospective Study)
Author(s) -
Sohrabi Bahram,
Kazemi Babak,
Mehryar Alireza,
TeimouriDereshki Amir,
Toufan Mehrnoush,
Aslanabadi Naser
Publication year - 2016
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.13000
Subject(s) - medicine , cardiology , pulmonary artery , cardiac catheterization , pulmonary hypertension , stenosis , doppler echocardiography , hemodynamics , heart catheterization , blood pressure , diastole
Right heart catheterization ( RHC ) remains the gold standard for hemodynamic assessment of the right heart and pulmonary artery. However, this is an invasive tool, and noninvasive alternatives such as transthoracic echocardiography ( TTE ) are preferable. Nonetheless, the correlation between measurements by TTE and RHC are debated. In this study, we prospectively examined the correlation between systolic and mean pulmonary artery pressures ( sPAP and mPAP ) measured by RHC and TTE in patients with hemodynamically significant rheumatic mitral stenosis ( MS ). Material and Methods Three hundred patients with hemodynamically significant MS undergoing TTE who were scheduled to undergo RHC within 24 hours were analyzed. PAP measurements were taken for all patients by RHC ( sPAP RHC , mPAP RHC ). Maximum velocity of tricuspid regurgitation ( TR ) jet obtained by continuous‐wave Doppler with adding right atrial ( RA ) pressure was used for measuring sPAP by TTE ( sPAP TRV max ). Mean PAP was measured using either pulmonary artery acceleration time ( mPAP PAAT ) method or by adding RA pressure to velocity–time integral of TR jet ( mPAP TRVTI ). Results A good correlation between sPAP RHC and sPAP TRV max (r = 0.89, P < 0.001), between mPAP RHC and mPAP PAAT (r = 0.9, P < 0.001), and between mPAP RHC and mPAP TRVTI (r = 0.92, P < 0.001) was found. Sensitivity and specificity of sPAP TRV max in detecting pulmonary hypertension ( PH ) were 92.8% and 86.6% and of mPAP PAAT were 94.1% and 73.3%, respectively. Conclusion The noninvasive assessment of sPAP and mPAP by TTE correlates well with invasive measurements and has an acceptable specificity and sensitivity in detecting PH in patients with hemodynamically significant MS.