Author + information
- Received June 20, 2002
- Revision received October 15, 2002
- Accepted November 11, 2002
- Published online March 19, 2003.
- Amr E Abbas, MD*,
- F.David Fortuin, MD*,
- Nelson B Schiller, MD, FACC†,
- Christopher P Appleton, MD, FACC*,
- Carlos A Moreno, BS* and
- Steven J Lester, MD, FACC*,* ()
- ↵*Reprint requests and correspondence:
Dr. Steven J. Lester, Division of Cardiovascular Diseases, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, Arizona 85259, USA.
Objectives We sought to test whether the ratio of peak tricuspid regurgitant velocity (TRV, ms) to the right ventricular outflow tract time-velocity integral (TVIRVOT, cm) obtained by Doppler echocardiography (TRV/TVIRVOT) provides a clinically reliable method to determine pulmonary vascular resistance (PVR).
Background Pulmonary vascular resistance is an important hemodynamic variable used in the management of patients with cardiovascular and pulmonary disease. Right-heart catheterization, with its associated disadvantages, is required to determine PVR. However, a reliable noninvasive method is unavailable.
Methods Simultaneous Doppler echocardiographic examination and right-heart catheterization were performed in 44 patients. The ratio of TRV/TVIRVOTwas then correlated with invasive PVR measurements using regression analysis. An equation was modeled to calculate PVR in Wood units (WU) using echocardiography, and the results were compared with invasive PVR measurements using the Bland-Altman analysis. Using receiver-operating characteristics curve analysis, a cutoff value for the Doppler equation was generated to determine PVR >2WU.
Results As calculated by Doppler echocardiography, TRV/TVIRVOTcorrelated well (r = 0.929, 95% confidence interval 0.87 to 0.96) with invasive PVR measurements. The Bland-Altman analysis between PVR obtained invasively and that by echocardiography, using the equation: PVR= TRV/TVIRVOT× 10 + 0.16 , showed satisfactory limits of agreement (mean 0 ± 0.41). A TRV/TVIRVOTcutoff value of 0.175 had a sensitivity of 77% and a specificity of 81% to determine PVR >2WU.
Conclusions Doppler echocardiography may provide a reliable, noninvasive method to determine PVR.
- Received June 20, 2002.
- Revision received October 15, 2002.
- Accepted November 11, 2002.
- American College of Cardiology Foundation