A simple method for noninvasive estimation of pulmonary vascular resistance

Abbas, Amr E.; Fortuin, F. David; Schiller, Nelson B.; Appleton, Christopher P.; Moreno, Carlos A.; Lester, Steven J.

doi:10.1016/s0735-1097(02)02973-x

Cited by 541 publications

(470 citation statements)

References 20 publications

Supporting

Mentioning

442

Contrasting

Unclassified

Order By: Relevance

“…However, previous validation studies correlating TRV/VTI RVOT to invasively measured PVR showed a robust correlation even in patients with increased right atrial pressure and pulmonary capillary wedge pressure. 3 Fourth, although after multivariate adjustment, increased PVR was independently predictive of heart failure hospitalization, the HRs for all-cause mortality and adverse cardiovascular events did not reach statistical significance. This may suggest a specific relation between PVR and incident heart failure in this patient population.…”

Section: Discussionmentioning

confidence: 83%

Usefulness of Noninvasive Estimate of Pulmonary Vascular Resistance to Predict Mortality, Heart Failure, and Adverse Cardiovascular Events in Patients With Stable Coronary Artery Disease (from the Heart and Soul Study)

Farzaneh‐Far¹,

Na²,

Whooley³

et al. 2008

The American Journal of Cardiology

View full text Add to dashboard Cite

Pulmonary vascular resistance (PVR) is an important hemodynamic variable that affects prognosis and therapy in a wide range of cardiovascular and pulmonary conditions. We sought to determine whether a noninvasive estimate of PVR predicts adverse outcomes in patients with stable coronary artery disease. Using Doppler echocardiography we measured the estimated PVR (defined as the ratio of the tricuspid regurgitant velocity [TRV] to the velocity-time integral [VTI] of the right ventricular outflow tract [RVOT]) in 795 ambulatory patients with stable coronary artery disease. Participants were categorized by quartiles of the TRV/VTI RVOT ratio. Hazard ratios (HRs) and 95% confidence intervals were calculated for all-cause mortality, heart failure hospitalization, and adverse cardiovascular events (cardiovascular death, nonfatal myocardial infarction, or stroke). After 4.3 years of follow-up there were 161 deaths, 44 deaths from cardiovascular causes, 103 heart failure hospitalizations, and 120 adverse cardiovascular events. Compared with patients in the lowest TRV/ VTI RVOT quartile, those in the highest quartile were at increased risk of all-cause mortality (unadjusted HR 1.8, 95% confidence interval 1.3 to 2.5), heart failure hospitalization (unadjusted HR 2.9, 95% confidence interval 2.0 to 4.3), and adverse cardiovascular events (unadjusted HR 2.0, 95% confidence interval 1.4 to 2.9). After multivariate adjustment, patients in the highest quartile were at increased risk of heart failure hospitalizations (adjusted HR 2.5, 95% confidence interval 1.3 to 4.7). In conclusion, a noninvasive estimate of PVR (TRV/VTI RVOT ratio) predicts mortality, heart failure hospitalization, and adverse cardiovascular events in patients with stable coronary artery disease.Doppler echocardiography has achieved widespread use as a noninvasive means of estimating pulmonary artery pressure. 1 We previously demonstrated that an increase in Doppler-estimated pulmonary artery pressures predicts mortality and heart failure hospitalization in patients with stable coronary artery disease. 2 Because flow and pressure in the pulmonary circulation can be measured noninvasively, we hypothesized that a previously validated echocardiographic estimate of pulmonary vascular resistance (PVR), the ratio of tricuspid regurgitant velocity (TRV) to the velocity-time integral (VTI) of the right ventricular outflow tract (RVOT), predicts adverse cardiovascular events independently of established risk factors, and provides incremental prognostic value beyond that provided by pulmonary artery pressure in patients with stable coronary artery disease. 3 *Corresponding author: Tel: 617-642-8373; fax: 415-376-1175. rfarzanehfar@medicine.ucsf.edu (R. Farzaneh-Far MethodsThe Heart and Soul Study is a prospective cohort study investigating the influence of psychosocial factors on cardiovascular events in outpatients with stable coronary artery disease. The enrollment process for the Heart and Soul Study has been previously described. 4 Eligible participan...

show abstract

Section: Discussionmentioning

confidence: 83%

Usefulness of Noninvasive Estimate of Pulmonary Vascular Resistance to Predict Mortality, Heart Failure, and Adverse Cardiovascular Events in Patients With Stable Coronary Artery Disease (from the Heart and Soul Study)

Farzaneh‐Far¹,

Na²,

Whooley³

et al. 2008

The American Journal of Cardiology

View full text Add to dashboard Cite

show abstract

“…2 On the other hand, formal radionuclide measurement of GFR was performed in the present series as serum creatinine has been considered as an inappropriate marker of renal function in nonazotemic cirrhotic patients.…”

Section: Dear Editormentioning

confidence: 90%

Renal Function Impairment in Patients With Cirrhosis Having Pulmonary Hypertension

et al. 2011

View full text Add to dashboard Cite

“…The peak tricuspid regurgitant velocity We calculated the echocardiographic PVR (WU) reported by Scapellato et al [2], that by Abbas et al in 2003 [3], that by Dahiya et al [4], that by Lindqvist et al [5], that by Abbas et al in 2013 [6], and that by our new method (PVR PR ) using the following equations: …”

Section: Echocardiographic Examinationmentioning

confidence: 99%

“…The systolic RV-right atrial pressure gradient can be noninvasively obtained using TRV [8], and it can be used to estimate the mean PA pressure as in the first and second Abbas [3,6], Dahiya [4], and Lindqvist methods [5]. However, a wide regurgitant orifice may develop most frequently in the tricuspid valve among the four cardiac valves, probably because of the easy distensibility of right heart structures around the tricuspid annulus [16,17].…”

Section: Kaga Et Al 12mentioning

confidence: 99%

“…However, the invasive nature of catheterization makes it difficult or impossible to perform daily or repetitive measurements of PVR. Although several noninvasive methods to estimate PVR based on echocardiographic measurements have been proposed [2][3][4][5][6][7], these methods used various empirical constants and/or ignored the left ventricular filling pressure, and thus their accuracy may be limited. The guidelines of the American Society of Echocardiography recommended not to use noninvasive estimations of PVR as a substitute for the invasive evaluation of PVR [8].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A new method to estimate pulmonary vascular resistance using diastolic pulmonary artery-right ventricular pressure gradients derived from continuous-wave Doppler velocity measurements of pulmonary regurgitation

Kaga

Mikami

Murayama

et al. 2016

Int J Cardiovasc Imaging

View full text Add to dashboard Cite

Purpose: Pulmonary vascular resistance (PVR) is an important hemodynamic parameter in patients with heart failure, especially when the pulmonary arterial pressure is lower due to reduced stroke volume. Several echocardiographic methods to estimate PVR have been proposed, but their applications in patients with organic left-sided heart diseases have been limited. The aim of the present study was to examine the usefulness of our new method to estimate PVR (PVR PR ) based on the continuous-wave Doppler velocity measurements of pulmonary regurgitation in these patients. Methods:In 43 patients who underwent right heart catheterization, PVR PR was calculated as the difference between the Doppler-derived early-and end-diastolic pulmonary artery (PA)-right ventricular (RV) pressure gradients divided by the cardiac output measured in the left ventricular outflow tract by echocardiography.

show abstract

A simple method for noninvasive estimation of pulmonary vascular resistance

Abstract: Doppler echocardiography may provide a reliable, noninvasive method to determine PVR.

Cited by 541 publications

References 20 publications

Usefulness of Noninvasive Estimate of Pulmonary Vascular Resistance to Predict Mortality, Heart Failure, and Adverse Cardiovascular Events in Patients With Stable Coronary Artery Disease (from the Heart and Soul Study)

Usefulness of Noninvasive Estimate of Pulmonary Vascular Resistance to Predict Mortality, Heart Failure, and Adverse Cardiovascular Events in Patients With Stable Coronary Artery Disease (from the Heart and Soul Study)

Renal Function Impairment in Patients With Cirrhosis Having Pulmonary Hypertension

A new method to estimate pulmonary vascular resistance using diastolic pulmonary artery-right ventricular pressure gradients derived from continuous-wave Doppler velocity measurements of pulmonary regurgitation

Contact Info

Product

Resources

About