Key Points
- To evaluate the clinical utility of tissue Doppler-derived right ventricular isovolumic relaxation time (rIVRT') for estimating systolic pulmonary artery pressure (sPAP) in routine practice.
- Prospective comparative study evaluating tissue Doppler imaging against invasive right heart catheterization in N=26 patients.
- Assessed tricuspid regurgitation detectability alongside rIVRT' feasibility and diagnostic correlation.
- Tricuspid regurgitation was undetectable in 32% of patients with normal sPAP and 14% of patients with pulmonary artery hypertension, whereas rIVRT' was successfully recorded in 100% of participants.
- rIVRT' showed a strong correlation with catheter-measured sPAP (r = 0.87, P < 0.0001).
- An rIVRT' of 40 ms or less ruled out pulmonary artery hypertension with a 100% negative predictive value, although prolonged rIVRT' was not specific and showed poor absolute agreement with catheter measurements.
Structured PICO
Does right ventricular isovolumic relaxation time assessed by tissue Doppler imaging accurately predict systolic pulmonary artery pressure compared to catheterization?
PPopulation26 patients undergoing prospective Doppler and catheterization study
IInterventionAssessment of right ventricular isovolumic relaxation time by tissue Doppler imaging (rIVRT')
CComparatorCatheterization (invasive measurement of systolic pulmonary artery pressure)
OOutcomeCorrelation between rIVRT' and systolic pulmonary artery pressure (sPAP), and diagnostic accuracy for pulmonary artery hypertension (PAH)surrogate
Measurement of rIVRT' by tissue Doppler imaging is a useful non-invasive tool to exclude pulmonary artery hypertension when tricuspid regurgitation is undetectable, though it lacks specificity for elevated sPAP.
Limitations
- Prolonged rIVRT' is not specific to PAH
- rIVRT'-evaluated sPAP did not agree well with the catheter-evaluated value