A Novel Echocardiographic Method for Estimation of Pulmonary Artery Wedge Pressure and Pulmonary Vascular Resistance

Figures

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  Figure 1. Non‐invasive estimation of pulmonary artery wedge pressure (PAWP) and pulmonary vascular resistance (PVR): equations and diagnostic accuracy of the model. (A) Distribution of the general population according to the clinical (left) and haemodynamic (right) classification. (B) Equations for echo‐derived estimation of PAWP and PVR. Echo‐parameters used for predicting PAWP and PVR: tricuspid regurgitation velocity (TRV),left ventricular ejection fraction (LVEF), right ventricular fractional area change (RVFAC), left atrial volume index (LAVi), mitral E/e′, inferior vena cava (IVC) diameter, mean pulmonary artery pressure (PAPm) and cardiac output (CO). (C) Regression analysis showing the strong relationship of the echo‐derived estimation of PAWP (on the left) and PVR (on the right) with the right heart catheterization (RHC) measures in the validation cohort. (D) Receiver operating characteristic (ROC) curve analysis of echo‐derived PAWP as a predictor of PAWP > 15 mmHg at RHC (on the left) and echo‐derived PVR as a predictor of PVR > 3 Wood units (WU) at RHC (on the right) in the validation cohort. AUC, area under the receiver operating characteristic curve; CTEPH, chronic…

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  Figure 2. Agreement between pulmonary artery wedge pressure measured at right heart catheterization (PAWPcath) and echo‐derived pulmonary artery wedge pressure (PAWPecho) in the validation group. Bland–Altman plots comparing PAWPecho with PAWPcath in patients without and with pulmonary hypertension (PH), as well as in different subgroups of PH according to the clinical classification. SD, standard deviation.

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  Figure 3. Agreement between pulmonary vascular resistance measured at right heart catheterization (PVRcath) and echo‐derived pulmonary vascular resistance (PVRecho) in the validation group. Bland–Altman plots comparing PVRecho with PVRcath in patients without and with pulmonary hypertension (PH), as well as in different subgroups of PH according to the clinical classification.