Erratum to: Echocardiographic assessment of pulmonary hypertension: a guideline protocol from the British Society of Echocardiography

Abstract

The error relates to the calculation of RVSP given on page G13. The original text stated:'When estimating right ventricular systolic pressure (RVSP) from the TRV using the Bernoulli equation, the TRV is squared and multiplied by 4, so even small errors in the absolute measurement of TRV can result in significant changes to the estimate of RVSP. Secondly, in order to obtain an estimate of PASP, the RVSP needs to be added to an estimate of the RAP derived from measurement of the inferior vena cava (IVC) dimensions and response to inspiration. However, in many patients, IVC dimensions cannot be obtained and even in those where measurement is possible, the accuracy between echo estimation of RAP and invasive measurement is as low as 34%'. This should have stated:'When estimating the peak pressure difference between the right ventricle (RV) and the right atrium (RA) from the tricuspid regurgitation velocity (TRV) using the simplified Bernoulli equation, the TRV is squared and multiplied by 4, so even small errors in the absolute measurement of TRV can result in significant changes to the estimation of the RV-RA pressure gradient. Secondly, in order to obtain an estimate of pulmonary artery systolic pressure (PASP), an estimate of the right atrial pressure (RAP) (derived from measurement of the inferior vena cava (IVC) dimensions and response to inspiration) needs to be added to the estimate of the RV-RA pressure gradient. However, in many patients, IVC dimensions cannot be obtained and even in those where measurement is possible, the accuracy between echo estimation of RAP and invasive measurement is as low as 34%'.

Cardiac Magnetic Resonance Imaging in Pulmonary Arterial Hypertension: Ready for Clinical Practice and Guidelines?

“…Ejection fraction is a crude measurement and while many patients with PAH have a preserved LVEF, and at times even a preserved RVEF, this should not be mistaken for a normal ventricular function. Regional RV function, such as myocardial strain (a deformation measured as a change in length; ΔL/ L), RV fractional area change, and tricuspid annular plane systolic excursion (TAPSE), are regularly assessed in patients with PAH using echocardiography [1,2]. Novel techniques to characterize regional ventricular function with CMR are emerging [20,23,[26][27][28][29][30][31].…”

“…Mortality is high and most commonly related directly or indirectly to right ventricular (RV) function [1]. While echocardiography currently is the first-line modality to assess cardiac function, assessment of RV volumes and function is challenged by the one-and two-dimensional nature of echocardiography [2][3][4][5]. With the complexity of the RV structure, cardiovascular magnetic resonance imaging (CMR) plays an important role in the diagnosis and follow-up of patients with PAH [1,6].…”

A practical guideline for performing a comprehensive transthoracic echocardiogram in adults: the British Society of Echocardiography minimum dataset

“…PWD of RV inflow velocities may be performed for the assessment of RV diastolic function 32 Full Doppler assessment of the PV (CFD, CWD, PWD) can also be performed in this view. Assess for pulmonary regurgitation (PR) and any abnormal flow 35 PSAX LV: MV level (2D/CFD)…”

AST/ALT ratio predicts the functional severity of chronic heart failure with reduced left ventricular ejection fraction

“…SPAP was estimated using the modified Bernoulli formula (SPAP [mmHg] = 4 × tricuspid regurgitation velocity 2 + right atrial pressure) [20].…”