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September 5, 2025Open Access

Tricuspid regurgitation velocity reflects pulmonary artery mean pressure better than systolic pressure in cardiogenic shock

HLHazem LashinSt Bartholomew's Hospital OOOlusegun OlusanyaSt Bartholomew's Hospital ASAndrew SmithSt Bartholomew's Hospital

Key Points

Tricuspid regurgitation velocity identified pulmonary artery mean pressure effectively, with a correlation coefficient of 0.54.
A TRV threshold of 2.3 m/s indicated high mean pressure with 81% sensitivity, allowing for improved patient assessment.
Exploratory analysis involved 35 patients experiencing ischemic cardiogenic shock, highlighting the need for non-invasive measurement alternatives.
Further validation in larger and more diverse cohorts is necessary to confirm the clinical utility of TRV as a monitoring tool.

Abstract

In this exploratory analysis of 35 patients with ischemic cardiogenic shock, we evaluated the correlation between tricuspid regurgitation velocity (TRV) and pulmonary artery catheter-derived pressures. TRV correlated best with pulmonary artery mean pressure ( r = 0.54, p = 0.0009), more than with systolic or diastolic pressures. A TRV threshold of 2.3 m/s identified mean pressure >25 mmHg with 81% sensitivity and 62% specificity. These findings suggest that TRV may serve as a non-invasive indicator of elevated pulmonary pressure in critically ill patients when invasive monitoring is unavailable. Further validation in larger, diverse cohorts is needed.

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