The noninvasive echo-Doppler method for assessing pulmonary arterial wave reflection agreed well with invasive catheter measurements (bias 0.13) in a canine model of pulmonary hypertension.
Does noninvasive Doppler echocardiography accurately estimate pulmonary arterial wave reflection compared to invasive catheter measurements in a canine model of pulmonary hypertension?
A novel echo-Doppler method accurately estimates pulmonary arterial wave reflection noninvasively, providing a potential flow-independent measure of right ventricular pulsatile load for early pulmonary hypertension diagnosis.
Effect estimate: bias 0.13 (95% CI -0.25 to 0.26)
Abstract Background: Pulmonary arterial (PA) wave reflection provides additional information for assessing right ventricular afterload, but its applications is hampered by the need for invasive pressure and flow measurements. We tested the hypothesis that PA pressure and flow waveforms estimated by Doppler echocardiography could be used to quantify PA wave reflection. Methods: Doppler echocardiographic images of tricuspid regurgitation and right ventricular outflow tract flow used to estimate PA pressure and flow waveforms were acquired simultaneously with direct measurements with a dual sensor-tipped catheter under various hemodynamic conditions in a canine model of pulmonary hypertension (n=8). Wave separation analysis was performed on echo-Doppler derived as well as catheter derived waveforms to separate PA pressure into forward (Pf) and backward (Pb) pressures and derive wave reflection coefficient (RC) defined as Pb divided by Pf. Results: RC by echo-Doppler agreed well with RC indices by catheter (RC: bias = 0.13, 95% limits of agreement = -0.25 to 0.26). RC correlated negatively with pulmonary arterial compliance and right ventricular systolic function. Conclusions: This echo-Doppler method yields accurate measurement of reflected wave in the pulmonary circulation, paving the way to a more integrative assessment of pulmonary hemodynamics in the clinical setting.
Yoshida et al. (2021) studied Pulmonary hypertension (n=8). Echo-Doppler method vs. Dual sensor-tipped catheter was evaluated on Reflection coefficient (RC) agreement between echo-Doppler and catheter (bias 0.13, 95% CI -0.25 to 0.26). The noninvasive echo-Doppler method for assessing pulmonary arterial wave reflection agreed well with invasive catheter measurements (bias 0.13) in a canine model of pulmonary hypertension.