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‐Far, Ramin; Na, Beeya; Whooley, Mary A.; Schiller, Nelson B.

doi:10.1016/j.amjcard.2007.11.010

Cited by 31 publications

(26 citation statements)

References 10 publications

(10 reference statements)

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“…DE has also been shown to provide an estimate of PVR, measured as the ratio of the tricuspid regurgitant velocity (TRV) to the VTI of the right ventricular outflow tract (RVOT). TRV/VTI RVOT has been shown to predict mortality and adverse cardiovascular events in patients with stable coronary artery disease (25). However, because the relation of TRV/VTI RVOT to PVR has been established in a population with an average PVR of 2 mm Hg/L/min, its application in patients with very high PVR values (i.e., pulmonary vascular disease) remains to be determined.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Doppler Echocardiography in the Hemodynamic Assessment of Pulmonary Hypertension

Fisher

Forfia

Chamera

et al. 2009

Am J Respir Crit Care Med

896

699

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Rationale: Transthoracic Doppler echocardiography is recommended for screening for the presence of pulmonary hypertension (PH). However, some recent studies have suggested that Doppler echocardiographic pulmonary artery pressure estimates may frequently be inaccurate. Objectives: Evaluate the accuracy of Doppler echocardiography for estimating pulmonary artery pressure and cardiac output. Methods: We conducted a prospective study on patients with various forms of PH who underwent comprehensive Doppler echocardiography within 1 hour of a clinically indicated right-heart catheterization to compare noninvasive hemodynamic estimates with invasively measured values. Measurements and Main Results: A total of 65 patients completed the study protocol. Using Bland-Altman analytic methods, the bias for the echocardiographic estimates of the pulmonary artery systolic pressure was 20.6 mm Hg with 95% limits of agreement ranging from 138.8 to 240.0 mm Hg. Doppler echocardiography was inaccurate (defined as being greater than 610 mm Hg of the invasive measurement) in 48% of cases. Overestimation and underestimation of pulmonary artery systolic pressure by Doppler echocardiography occurred with a similar frequency (16 vs. 15 instances, respectively). The magnitude of pressure underestimation was greater than overestimation (230 6 16 vs. 119 6 11 mm Hg; P 5 0.03); underestimates by Doppler also led more often to misclassification of the severity of the PH. For cardiac output measurement, the bias was 20.1 L/min with 95% limits of agreement ranging from 12.2 to 22.4 L/min. Conclusions: Doppler echocardiography may frequently be inaccurate in estimating pulmonary artery pressure and cardiac output in patients being evaluated for PH.Keywords: echocardiography; pulmonary hypertension; pulmonary systolic pressure; cardiac output; accuracy Pulmonary hypertension (PH), a syndrome characterized by increased pulmonary vascular resistance and remodeling, is associated with significant morbidity and mortality, which are directly related to cardiac function (1). Although the definitive diagnosis of PH is currently established through right-heart catheterization, accurate noninvasive assessment of pulmonary arterial pressure and cardiac output (CO) is desirable both for diagnostic purposes and to assess response to therapy.Transthoracic Doppler echocardiography (DE) is recommended as the initial noninvasive modality in the screening and evaluation of PH (2). Echocardiography can be used to evaluate right-sided chamber size and function and the presence of pericardial effusion, which are known to impact survival (3-5). Frequently, DE is used to estimate the right ventricular systolic pressure by estimating the pressure gradient between the right ventricle and the right atrium using the modified Bernoulli equation, 4v 2 , where v equals the velocity of the tricuspid regurgitant jet. An estimated right atrial pressure is added to this number to approximate the right ventricular systolic pressure, which equals the pulmonary artery systolic pres...

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Section: Discussionmentioning

confidence: 99%

Accuracy of Doppler Echocardiography in the Hemodynamic Assessment of Pulmonary Hypertension

Fisher

Forfia

Chamera

et al. 2009

Am J Respir Crit Care Med

896

699

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“…A TRV of 2.5 m/sec or greater is also associated with a high risk of death in other conditions, such as congestive heart failure. 25 This association between increased TRV and mortality in SCD is significant, and has been confirmed in multiple studies, 20,21,[26][27][28] although it remains to be determined whether this measurement and, its association with mortality, reflects true pulmonary hypertension per se, or is a biomarker of disease severity and systemic vasculopathy in SCD. Right heart catheterization studies suggested that 6-11% of adults with SCD have pulmonary hypertension defined by a mean pulmonary artery pressure greater than or equal to 25 mmHg.…”

Section: Pulmonary Hypertension In Adults With Sickle Cell Diseasementioning

confidence: 94%

Vascular risk assessment in patients with sickle cell disease

Morris¹

2010

Haematologica

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“…A RVP pode ser estimada pela simples relação do pico da IT (em metros por segundo) pela integral da velocidade pelo tempo do fluxo na VSVD (em centímetros). [87][88][89] Esta relação não é confiável em RVP muito elevadas, com valores > 8 Wood, conforme calculada por métodos hemodinâmicos invasivos.90 Um dos métodos para determinar a RVP está ilustrado na Figura 14.…”

Section: Resistência Vascular Pulmonarunclassified

Guidelines for the Echocardiographic Assessment of the Right Heart in Adults: A Report from the American Society of Echocardiography

Rudski¹,

Lai²,

Afilalo³

et al. 2014

Arquivos Brasileiros De Cardiologia - Imagem Cardiovascular

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216

363

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Divulgação do autor: Os autores desse artigo não relataram nenhum conflito de interesse atual ou potencial em relação a essa atividade. Os autores e revisores RVT, FASE; Farooq A. Chaudhry, MD, FASE; Robert T. Eberhardt, MD; Benjamin W. Eidem, MD, FASE; Gregory J.Ensing, MD, FASE; Tal Geva, MD, FASE; Kathryn E. Glas, MD, FASE; Sandra Hagen-Ansert, RDCS, RDMS,MS, FASE; Rebecca T. Hahn, MD, FASE; Jeannie Heirs, RDCS; Shunichi Homma, MD; Sanjiv Kaul, MD,FASE; Smadar Kort, MD, FASE; Peg Knoll, RDCS, FASE; Wyman Lai, MD, MPH, FASE; Roberto M. Lang,MD, FASE; Steven Lavine, MD; Steven J. Lester, MD, FASE; Renee Margossian, MD; Victor Mor-Avi,PhD, FASE; Sherif Nagueh, MD, FASE; Alan S. Pearlman, MD, FASE; Patricia A. Pellikka, MD, FASE; MiguelQuinones, MD, FASE; Brad Roberts, RCS, RDCS; Beverly Smulevitz, BS, RDCS, RVS; Kirk T. Spencer,MD, FASE; J. Geoffrey Stevenson, MD, FASE; Wadea Tarhuni, MD, FASE; James D. Thomas, MD; Neil J.Weissman, MD, FASE; Timothy Woods, MD; and William A. Zoghbi, MD, FASE. Os

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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)

Cited by 31 publications

References 10 publications

Accuracy of Doppler Echocardiography in the Hemodynamic Assessment of Pulmonary Hypertension

Accuracy of Doppler Echocardiography in the Hemodynamic Assessment of Pulmonary Hypertension

Vascular risk assessment in patients with sickle cell disease

Guidelines for the Echocardiographic Assessment of the Right Heart in Adults: A Report from the American Society of Echocardiography

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