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The relationship between pulmonary artery wedge pressure and pulmonary blood volume derived from contrast echocardiography: A proof‐of‐concept study
Author(s) -
Monahan Ken,
Lenihan Daniel,
Brittain Evan L.,
Saliba Linda,
Piana Robert N.,
Robison Leslie L.,
Hudson Melissa M.,
Armstrong Gregory T.
Publication year - 2018
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.14023
Subject(s) - pulmonary wedge pressure , cardiology , pulmonary artery , medicine , contrast (vision) , wedge (geometry) , mathematics , computer science , geometry , artificial intelligence
Background Pulmonary transit time (PTT) obtained from contrast echocardiography is a marker of global cardiopulmonary function. Pulmonary blood volume (PBV), derived from PTT, may be a noninvasive surrogate for left‐sided filling pressures, such as pulmonary artery wedge pressure (PAWP). We sought to assess the relationship between PBV obtained from contrast echocardiography and PAWP. Methods Participants were adult survivors of childhood cancer that had contrast echocardiography performed nearly simultaneously with right‐heart catheterization. PTT was derived from time‐intensity curves of contrast passage through the right ventricle (RV) and left atrium (LA). PBV relative to overall stroke volume (rPBV) was estimated from the product of PTT and heart rate during RV‐LA transit. PAWP was obtained during standard right‐heart catheterization. The Spearman correlation coefficient was used to assess the relationship between rPBV and PAWP. Results The study population consisted of 7 individuals who had contrast echocardiography and right‐heart catheterization within 3 hours of each other. There was a wide range of right atrial (1–17 mm Hg), mean pulmonary artery (18–42 mm Hg), and PAW pressures (4–26 mm Hg) as well as pulmonary vascular resistance (<1–6 Wood Units). We observed a statistically significant correlation between rPBV and PAWP ( r = .85; P = .02). Conclusion Relative PBV derived from contrast echocardiography correlates with PAWP. If validated in larger studies, rPBV could potentially be used as an alternative to invasively determine left‐sided filling pressure.