Document Detail


Accuracy of noninvasively determined pulmonary artery systolic pressure.
MedLine Citation:
PMID:  20381676     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The noninvasive estimation of pulmonary artery systolic pressure (PASP) has become a standard component of the echocardiographic examination. Our aim was to evaluate the accuracy of this modality in a large series of unselected studies obtained in clinical practice. All right heart catheterizations during a 4-year period were reviewed. Studies with echocardiographic findings available within 48 hours were evaluated for PASP agreement. In an effort to mirror clinical practice, the right heart catheterization findings were used as the reference standard and the PASP values were taken directly from the respective clinical reports. Overall, 792 right heart catheterization-echocardiogram pairs were identified. Echocardiographic PASP could not be estimated in 174 of these studies (22.0%). The correlation between modalities was moderate, but agreement was poor (bias 9.0%, 95% limits of agreement -53.2% to 71.2%, r = 0.52, p <0.001). Misclassification of clinical PASP categories occurred more often than not (54.4%). Multivariate analysis using multiple potential sources of error could only account for 3.2% of the total variation in the discrepancy between the study modalities (p = 0.003). In conclusion, noninvasively estimated PASP had limited agreement with the invasively determined PASP, and misclassification of PASP clinical categories occurred frequently. Given the widespread use of echocardiographically determined PASP, these data are in need of replication in a large prospective study.
Authors:
Jeffrey M Testani; Martin G St John Sutton; Susan E Wiegers; Amit V Khera; Richard P Shannon; James N Kirkpatrick
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-03-05
Journal Detail:
Title:  The American journal of cardiology     Volume:  105     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-12     Completed Date:  2010-06-15     Revised Date:  2011-09-26    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1192-7     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Affiliation:
Cardiovascular Division, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA. jeffrey.testani@uphs.upenn.edu
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure Determination / methods*,  standards
Data Interpretation, Statistical
Echocardiography / methods*
Heart Catheterization
Humans
Prospective Studies
Pulmonary Wedge Pressure / physiology*
ROC Curve
Reproducibility of Results
Systole
Grant Support
ID/Acronym/Agency:
T32 HL007843-15/HL/NHLBI NIH HHS
Comments/Corrections
Comment In:
Am J Cardiol. 2010 Oct 1;106(7):1059-60; author reply 1060   [PMID:  20854976 ]
Erratum In:
Am J Cardiol. 2010 Oct 1;106(7):1060

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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