Key result
Doppler echo estimates of systolic RV pressure correlate closely with invasive catheterization measurements at ~0.96.
Why the study?
Noninvasive estimation of systolic right ventricular pressure in patients with tricuspid regurgitation requires validation against invasive measurements.
Does noninvasive estimation using Doppler echocardiography accurately correlate with invasive measurements of systolic right ventricular pressure in patients with tricuspid regurgitation?
Observational (n=70)
Does noninvasive estimation using Doppler echocardiography accurately correlate with invasive measurements of systolic right ventricular pressure in patients with tricuspid regurgitation?
Doppler echocardiography using the simplified Bernoulli equation provides an accurate noninvasive estimation of systolic right ventricular pressure in patients with tricuspid regurgitation.
May support Doppler echo for RV pressure estimation in TR; leaves open prospective validation before clinical adoption.
In 70 patients, tricuspid regurgitation was diagnosed with Doppler by recording reverse flow in systole originating at the tricuspid orifice, directed into the right atrium. The peak velocities were recorded, and the peak pressure drop from the right ventricle to the right atrium in systole was calculated from the simplified Bernoulli equation (pressure drop = 4 X 4 X Vmax2), and was found to correlate well with invasive measurements (r = 0.97, SEE +/- 6.1 mmHg). Central venous pressure was judged by neck vein congestion and added to the pressure drop to obtain a noninvasive estimation of systolic right ventricular pressure. Correlation with catheterization measurements was good (r = 0.96, SEE +/- 7.1 mmHg). In patients in whom the tricuspid regurgitation was judged as mild with Doppler, the correlation between noninvasive and invasive measurements of the transtricuspid pressure drop was still good (r = 0.95, SEE +/- 5.1 mmHg), indicating that the viscosity of the blood does not invalidate the use of the simplified Bernoulli equation when the regurgitant area of the valve is small.
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Skjærpe et al. (1986) conducted an observational in Tricuspid regurgitation (n=70). Doppler echocardiography with simplified Bernoulli equation vs. Invasive catheterization measurements was evaluated on Correlation of systolic right ventricular pressure between noninvasive and invasive measurements (r = 0.96). Noninvasive estimation of systolic right ventricular pressure using Doppler echocardiography correlated well with invasive catheterization measurements (r = 0.96).
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