Echocardiography accurately estimated right heart pressures (mean difference <2 mmHg) and detected pulmonary hypertension (97% sensitivity), but poorly estimated PCWP and PVR.
Observational (n=115)
Does transthoracic echocardiography accurately and precisely estimate right heart hemodynamics compared to right heart catheterization in patients with known or suspected pulmonary hypertension?
Echocardiography provides accurate estimates of right heart pressures and cardiac output for diagnosing pulmonary hypertension, but lacks the precision to reliably calculate pulmonary vascular resistance or classify post-capillary PH.
BACKGROUND: Echocardiography (ECHO) plays a key role in both the diagnosis and prognosis of pulmonary hypertension (PH). Many equations have been published to assess right heart hemodynamics using ECHO. The objective of this study was to test the accuracy and precision of different echocardiographic equations in comparison with the right heart catheterization. METHODS AND RESULTS: Complete right heart hemodynamic assessments were prospectively obtained from 115 individuals (mean age 66±1 years; 57 males) who had known or suspected PH. Several equations were tested for the estimation of right atrial pressure, mean and systolic pulmonary artery pressure (MPAP), cardiac output, pulmonary capillary wedge pressure (PCWP), and pulmonary vascular resistance (PVR). The accuracy of ECHO was good, with a mean difference <2 mmHg for all of the pressure calculations and ±0.6 L/min for cardiac output. However, the PVR estimation was weak using any one of the formulae. For all the parameters, the precision of ECHO was moderate. The MPAP calculation detected PH with a sensibility of 97% and specificity of 83%. However, ECHO underdiagnosed post-capillary PH. CONCLUSIONS: ECHO is a good method for the diagnosis of PH, with an adequate calculation of right pressures, but cannot accurately calculate PCWP and PVR. (Circ J 2016; 80: 2019-2025).
Doutreleau et al. (Fri,) conducted a observational in Pulmonary hypertension (n=115). Echocardiography vs. Right heart catheterization was evaluated on Accuracy and precision of different echocardiographic equations for right heart hemodynamics. Echocardiography accurately estimated right heart pressures (mean difference <2 mmHg) and detected pulmonary hypertension (97% sensitivity), but poorly estimated PCWP and PVR.