1. USEFULNESS OF THE CONTINUOUS-WAVE DOPPLER-DERIVED PULMONARY ARTERIAL-RIGHT VENTRICULAR PRESSURE GRADIENT JUST BEFORE ATRIAL CONTRACTION FOR THE ESTIMATION OF PULMONARY ARTERIAL DIASTOLIC AND WEDGE PRESSURES
- Author
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Shinobu Yokoyama, Mutsumi Nishida, Taisei Mikami, Hiroyuki Iwano, Satoshi Yamada, Kazunori Okada, Sanae Kaga, Hisao Nishino, Masahiro Nakabachi, Nobuo Masauzi, Michito Murayama, Takuma Hioka, Mamoru Sakakibara, and Hiroyuki Tsutsui
- Subjects
Adult ,Male ,medicine.medical_specialty ,Contraction (grammar) ,Acoustics and Ultrasonics ,Heart disease ,Heart Ventricles ,Biophysics ,Diastole ,Pulmonary arterial diastolic pressure ,Blood Pressure ,Pulmonary regurgitation ,030204 cardiovascular system & hematology ,Pulmonary Artery ,Pulmonary arterial wedge pressure ,Right atrial contraction ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Ventricular Function ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,Pulmonary Wedge Pressure ,Pulmonary wedge pressure ,Pressure gradient ,Aged ,Retrospective Studies ,Aged, 80 and over ,Radiological and Ultrasound Technology ,Receiver operating characteristic ,business.industry ,Reproducibility of Results ,Middle Aged ,medicine.disease ,Atrial Function ,Continuous-wave Doppler echocardiography ,Echocardiography, Doppler ,Heart catheterization ,Ventricular pressure ,Cardiology ,Female ,business - Abstract
In our new echocardiographic method, pulmonary regurgitant velocity immediately before right atrial (RA) contraction is used to estimate pulmonary artery diastolic pressure (PADP) and mean PA wedge pressure (MPAWP). Our aim here was to compare the usefulness of this new method with that of the conventional method, which uses pulmonary regurgitant velocity at end diastole. We studied 55 consecutive patients who underwent echocardiography and right-sided heart catheterization. The pulmonary regurgitant velocities just before RA contraction and at end diastole were measured to obtain echocardiographic estimates of PADP (EPADP preA and EPADP ED , respectively) by adding the pressure gradients to the echocardiographically estimated RA pressure. Compared with EPADP ED , EPADP preA correlated better with PADP ( r = 0.87) and MPAWP ( r = 0.80), and direct fixed biases were detected for EPADP ED but not for EPADP preA . The area under the receiver operating characteristic curve distinguishing patients with MPAWP ≥18 mm Hg was greater for EPADP preA (0.97) than for E / e ′ (0.94) and E / A (0.83). EPADP preA is thus useful in estimating PADP and MPAWP in patients with heart disease.
- Published
- 2017