Key result
Doppler parameter RVPEP/VTI strongly correlates with PVR and identifies low resistance with 97% accuracy.
Why the study?
Does Doppler echocardiography accurately estimate pulmonary vascular resistance compared to cardiac catheterization in children with congenital heart disease?
Cross-Sectional (n=33)
Does Doppler echocardiography accurately estimate pulmonary vascular resistance compared to cardiac catheterization in children with congenital heart disease?
Effect estimate: r = 0.87
p-value: p=< 0.0001
The Doppler echocardiographic parameter RVPEP/VTI provides a highly accurate, noninvasive method to estimate pulmonary vascular resistance in children with congenital heart disease.
May support noninvasive PVR estimation in pediatric congenital heart disease; leaves open prospective validation before clinical adoption.
Noninvasive assessment of pulmonary vascular resistance has not been well defined. Cardiac catheterization findings in 33 patients with congenital heart disease (mean age 1.4 years) were compared with Doppler echocardiographic parameters. The right ventricular pre-ejection period (RVPEP), ejection time (RVET), and the ration RVPEP/RVET correlated better with pulmonary vascular resistance than with pulmonary artery pressure. A highly significant correlation with a small standard error of estimate (SEE) was demonstrated between pulmonary vascular resistance and a newly derived parameter RVPEP/velocity time integral (VTI) [r = 0.87, p < 0.0001, SEE = 2]. An RVPEP/VTI value of < 0.4 seconds/meter (M) was able to select patients with pulmonary vascular resistance < 3 Wood Unit.M2, even in the presence of pulmonary artery hypertension caused by increased pulmonary blood flow, with 97% accuracy (100% sensitivity, and 92% specificity). An RVPEP/VTI value of 0.4 to 0.6 seconds/M identified patients with pulmonary vascular resistance between 3 to 7.5 Wood Unit.M2 with 91% accuracy, and a value of > or = 0.6 seconds/ M selected patients with total pulmonary vascular resistance > or = 7.5 Wood Unit.M2 with 94% accuracy.
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Ebeid et al. (1996) conducted a cross-sectional in congenital heart disease (n=33). Doppler echocardiographic parameters (RVPEP/VTI) vs. Cardiac catheterization was evaluated on Correlation between pulmonary vascular resistance and RVPEP/VTI (r = 0.87, p=< 0.0001). The Doppler echocardiographic parameter RVPEP/VTI strongly correlated with pulmonary vascular resistance (r = 0.87, p < 0.0001) and identified resistance < 3 Wood Units with 97% accuracy.
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