March 15, 1996Circulation
Relation of Mean Right Atrial Pressure to Echocardiographic and Doppler Parameters of Right Atrial and Right Ventricular Function
Key result
Hepatic venous flow systolic filling fraction strongly correlated with mean right atrial pressure (r=0.88) and estimated mean RAP >8 mm Hg with 86% sensitivity and 92% specificity.
Why the study?
Can echocardiographic and Doppler parameters, specifically hepatic venous flow dynamics, accurately estimate mean right atrial pressure in patients undergoing invasive hemodynamic monitoring?
Population
85 consecutive patients who either had a central venous catheter in the Intensive Care Unit or underwent…
Comparison
Echocardiographic and Doppler assessment of… vs Invasive measurement of mean right atrial pressure
Design
Cross-sectional
Authors
Discussion
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Implication
May support noninvasive RAP estimation; hypothesis-generating and requires prospective validation before practice change.
Key Points
- This research aims to examine the relationship between mean right atrial pressure and various echocardiographic and Doppler parameters of right atrial and right ventricular function.
- Simultaneous Doppler and echocardiographic studies performed in 35 consecutive patients in ICU or during right heart catheterization.
- Collected data includes mean RAP measurements and various echocardiographic parameters of heart function.
- Evaluation of correlations between Doppler filling dynamics and mean RAP, with additional analyses in a prospective group of 50 patients.
- Strongest relation observed between mean RAP and the ratio of early to late velocity with r=0.66.
- Best correlation for hepatic venous flow found for systolic filling fraction with r=-0.86; weak relations noted for other parameters.
- The regression equation for estimating RAP demonstrated high correlation coefficients of 0.89 and 0.88 in prospective and total groups, respectively.
Study Design
Type
Cross-Sectional (n=85)
Structured PICO
Can echocardiographic and Doppler parameters, specifically hepatic venous flow dynamics, accurately estimate mean right atrial pressure in patients undergoing invasive hemodynamic monitoring?
P
Population
85 consecutive patients (initial group n=35, prospective group n=50) who either had a central venous catheter in the Intensive Care Unit or underwent catheterization of the right side of the heart. Initial group mean age 60+/-15 years, 34% on mechanical ventilation.
I
Intervention
Echocardiographic and Doppler assessment of right atrial and right ventricular function, specifically hepatic venous flow dynamics (systolic filling fraction)
C
Comparator
Invasive measurement of mean right atrial pressure (RAP)
O
Outcome
Correlation between echocardiographic/Doppler parameters and invasively measured mean right atrial pressuresurrogate
Main Result
Effect estimate: r=0.88
Hepatic venous flow dynamics, particularly systolic filling fraction, provide a reliable non-invasive echocardiographic estimate of mean right atrial pressure.
Cite This Study
Nagueh et al. (1996) conducted a cross-sectional in Patients requiring central venous or right heart catheterization (n=85). Echocardiographic and Doppler parameters vs. Invasive mean right atrial pressure was evaluated on Correlation between hepatic venous flow systolic filling fraction and mean right atrial pressure (r=0.88). Hepatic venous flow systolic filling fraction strongly correlated with mean right atrial pressure (r=0.88) and estimated mean RAP >8 mm Hg with 86% sensitivity and 92% specificity.