Pulmonary arterial diastolic pressure and its gradient with left atrial mean pressure are highly correlated with pulmonary vascular resistance in patients with congenital heart disease and left-to-right shunt, serving as a clinically important index.
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Supports PAdp-LAmp gradient as potential Rp/Rs index in congenital shunts; hypothesis-generating and requires prospective validation.
Our studies recently conducted on the correlation between pulmonary vascular resistance and pulmonary arterial diastolic pressure in 467 cases, identified an extremely high correlation between the two. The correlation coefficient between pulmonary arterial diastolic pressure (PAdp) and pulmonary to systemic resistance ratio (Rp/Rs) was 0.799 and that between pulmonary vascular resistance index (RP-index) and PAdp was found to be 0.791. And a still higher correlation was observed between pulmonary vascular resistance and pressure gradient between PAdp and left atrial mean pressure (LAmp), where the correlation coefficient between Rp/Rs and (PAdp-LAmp) was 0.851 and that between Rp-index and (PAdp-LAmp) was 0.813. Those correlations are found to be higher in degree than the correlations between pulmonary arterial mean pressure or pulmonary arterial systolic pressure and pulmonary vascular resistance, leading to the conclusion that the pulmonary arterial diastolic pressure is of extremely high clinical importance as an index for increase in pulmonary vascular resistance.
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Honda et al. (1975) studied this question.
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