Doppler echocardiography accurately estimated right ventricular peak positive (r=0.98) and negative (r=0.93) dP/dt compared to catheterization, though high right atrial pressure caused underestimation.
Observational (n=11)
Can continuous wave Doppler echocardiography accurately estimate right ventricular peak positive and negative dP/dt compared to catheterization?
Continuous wave Doppler echocardiography can accurately and noninvasively estimate right ventricular dP/dt, though it may underestimate peak negative dP/dt in patients with high right atrial pressure.
Effect estimate: r = 0.98 (positive dP/dt); r = 0.93 (negative dP/dt)
OBJECTIVES: The present study aimed to validate the peak positive and negative values of the first derivative of right ventricular pressure (dP/dt) using Doppler echocardiography and to determine the impact of right atrial pressure on the measurements. BACKGROUND: A pressure gradient between the right ventricle and the right atrium can be obtained by continuous wave Doppler-derived tricuspid regurgitant velocity using the simplified Bernoulli equation. If right atrial pressure fluctuation during systole and isovolumic diastole were small compared with right ventricular pressure changes, right ventricular pressure could be evaluated, and maximal positive and negative dP/dt could also be determined with Doppler echocardiography. METHODS: We investigated 11 patients with a wide range of right atrial pressure with tricuspid regurgitation using simultaneous examination by Doppler ultrasound and catheterization. Hemodynamic conditions were altered by the Valsalva maneuver, and a total of 40 beats were analyzed. RESULTS: There was good correlation between Doppler-derived and catheterization-derived peak positive dP/dt (y = 1.0x - 15.4, r = 0.98, n = 40), irrespective of the level of right atrial pressure. Doppler-derived peak negative dP/dt also showed good correlation with that determined by catheterization (y = 0.9x + 58.2, r = 0.93, n = 40). However, in patients with high right atrial pressure (v wave pressure > or = 10 mm Hg), Doppler-derived peak negative dP/dt tended to show lower values than those from catheterization measurements, except in patients with pulmonary hypertension. CONCLUSIONS: We conclude that right ventricular dP/dt can be estimated by the Doppler method accurately and noninvasively. However, when right atrial pressure is relatively high compared with corresponding right ventricular pressure changes during isovolumic diastole, Doppler-derived peak negative dP/dt might underestimate catheter-derived measurements.
Imanishi et al. (Wed,) conducted a observational in Tricuspid regurgitation (n=11). Doppler echocardiography vs. Catheterization was evaluated on Correlation of peak positive and negative dP/dt between Doppler and catheterization (r = 0.98 (positive dP/dt); r = 0.93 (negative dP/dt)). Doppler echocardiography accurately estimated right ventricular peak positive (r=0.98) and negative (r=0.93) dP/dt compared to catheterization, though high right atrial pressure caused underestimation.
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