OBJECTIVES: We sought to test whether the ratio of peak tricuspid regurgitant velocity (TRV, ms) to the right ventricular outflow tract time-velocity integral (TVI(RVOT), cm) obtained by Doppler echocardiography (TRV/TVI(RVOT)) provides a clinically reliable method to determine pulmonary vascular resistance (PVR). BACKGROUND: Pulmonary vascular resistance is an important hemodynamic variable used in the management of patients with cardiovascular and pulmonary disease. Right-heart catheterization, with its associated disadvantages, is required to determine PVR. However, a reliable noninvasive method is unavailable. METHODS: Simultaneous Doppler echocardiographic examination and right-heart catheterization were performed in 44 patients. The ratio of TRV/TVI(RVOT) was then correlated with invasive PVR measurements using regression analysis. An equation was modeled to calculate PVR in Wood units (WU) using echocardiography, and the results were compared with invasive PVR measurements using the Bland-Altman analysis. Using receiver-operating characteristics curve analysis, a cutoff value for the Doppler equation was generated to determine PVR >2WU. RESULTS: As calculated by Doppler echocardiography, TRV/TVI(RVOT) correlated well (r = 0.929, 95% confidence interval 0.87 to 0.96) with invasive PVR measurements. The Bland-Altman analysis between PVR obtained invasively and that by echocardiography, using the equation: PVR = TRV/TVI(RVOT) x 10 + 0.16, showed satisfactory limits of agreement (mean 0 +/- 0.41). A TRV/TVI(RVOT) cutoff value of 0.175 had a sensitivity of 77% and a specificity of 81% to determine PVR >2WU. CONCLUSIONS: Doppler echocardiography may provide a reliable, noninvasive method to determine PVR.
OBJECTIVES: We sought to test whether the ratio of peak tricuspid regurgitant velocity (TRV, ms) to the right ventricular outflow tract time-velocity integral (TVI(RVOT), cm) obtained by Doppler echocardiography (TRV/TVI(RVOT)) provides a clinically reliable method to determine pulmonary vascular resistance (PVR). BACKGROUND: Pulmonary vascular resistance is an important hemodynamic variable used in the management of patients with cardiovascular and pulmonary disease. Right-heart catheterization, with its associated disadvantages, is required to determine PVR. However, a reliable noninvasive method is unavailable. METHODS: Simultaneous Doppler echocardiographic examination and right-heart catheterization were performed in 44 patients. The ratio of TRV/TVI(RVOT) was then correlated with invasive PVR measurements using regression analysis. An equation was modeled to calculate PVR in Wood units (WU) using echocardiography, and the results were compared with invasive PVR measurements using the Bland-Altman analysis. Using receiver-operating characteristics curve analysis, a cutoff value for the Doppler equation was generated to determine PVR >2WU. RESULTS: As calculated by Doppler echocardiography, TRV/TVI(RVOT) correlated well (r = 0.929, 95% confidence interval 0.87 to 0.96) with invasive PVR measurements. The Bland-Altman analysis between PVR obtained invasively and that by echocardiography, using the equation: PVR = TRV/TVI(RVOT) x 10 + 0.16, showed satisfactory limits of agreement (mean 0 +/- 0.41). A TRV/TVI(RVOT) cutoff value of 0.175 had a sensitivity of 77% and a specificity of 81% to determine PVR >2WU. CONCLUSIONS: Doppler echocardiography may provide a reliable, noninvasive method to determine PVR.
Authors: Brian D Hoit; Nancy D Dalton; Amha Gebremedhin; Allison Janocha; Peter A Zimmerman; Allison M Zimmerman; Kingman P Strohl; Serpil C Erzurum; Cynthia M Beall Journal: Am J Hum Biol Date: 2010-12-22 Impact factor: 1.937
Authors: Michelle L Freeman; Carolyn Landolfo; Robert E Safford; Cesar A Keller; Michael G Heckman; Charles D Burger Journal: South Med J Date: 2013-02 Impact factor: 0.954
Authors: Amil M Shah; Susan Cheng; Hicham Skali; Justina Wu; Judy R Mangion; Dalane Kitzman; Kunihiro Matsushita; Suma Konety; Kenneth R Butler; Ervin R Fox; Nakela Cook; Hanyu Ni; Josef Coresh; Thomas H Mosley; Gerardo Heiss; Aaron R Folsom; Scott D Solomon Journal: Circ Cardiovasc Imaging Date: 2013-11-08 Impact factor: 7.792
Authors: Kotaro Nochioka; Gabriela Querejeta Roca; Brian Claggett; Tor Biering-Sørensen; Kunihiro Matsushita; Chung-Lieh Hung; Scott D Solomon; Dalane Kitzman; Amil M Shah Journal: JAMA Cardiol Date: 2018-10-01 Impact factor: 14.676