| Echocardiography can identify patients with increased pulmonary vascular resistance by assessing pressure reflection in the pulmonary circulation. | |
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MedLine Citation:
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PMID: 20448141 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Pulmonary hypertension is a frequent finding in patients with cardiopulmonary disorders. It is important to recognize pulmonary hypertension due to increased pulmonary vascular resistance (PVR), as this affects treatment and prognosis. Patients with increased PVR have an increased pulmonary pressure reflection. We hypothesized that pressure reflection can be described by echocardiography and that variables related to pressure reflection can identify patients with increased PVR. METHODS AND RESULTS: The study comprised 98 patients investigated within 24 hours of right heart catheterization and 20 control subjects. The pressure reflection variables were obtained by pulsed Doppler in the pulmonary artery and continuous Doppler of tricuspid regurgitation. We selected 3 variables related to pressure reflection: the interval from valve opening to peak velocity in the pulmonary artery (AcT, ms), the interval between pulmonary artery peak velocity and peak tricuspid velocity (tPV-PP, ms), and the right ventricular pressure increase after peak velocity in the pulmonary artery (augmented pressure, AP, mm Hg). The correlation between simultaneous catheter- and echocardiography-determined AP was strong (n=19, R=0.83). The AcT, tPV-PP, and AP in patients with a PVR of >3 Woods units (n=71) was (mean+/-SD) 77+/-16 ms, 119+/-36 ms, and 22+/-12 mm Hg, respectively, and differed from patients with a PVR of </=3 Woods units (n=27, P<0.0001), 111+/-32 ms, 39+/-54 ms, and 3+/-4 mm Hg, and from controls, 153+/-32 ms, -19+/-45 ms, and 0 mm Hg, respectively (P<0.0001). The AcT, tPV-PP, and AP values were not correlated with capillary wedge pressure (R=0.08-0.16). The areas under the receiver operator characteristic curve (95%CI) for AcT, tPV-PP, and AP were 0.87 (0.82 to 0.95), 0.94 (0.89 to 0.99), and 0.98 (0.95 to 1.0), respectively. CONCLUSIONS: In this study, we describe a novel echocardiography method for assessing pressure reflection in the pulmonary circulation. This method can be used to identify patients with pulmonary hypertension due to increased PVR. |
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Authors:
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Odd Bech-Hanssen; Fredrik Lindgren; Nedim Selimovic; Bengt Rundqvist |
Publication Detail:
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Type: Journal Article Date: 2010-05-06 |
Journal Detail:
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Title: Circulation. Cardiovascular imaging Volume: 3 ISSN: 1942-0080 ISO Abbreviation: Circ Cardiovasc Imaging Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-07-21 Completed Date: 2010-08-12 Revised Date: 2011-09-06 |
Medline Journal Info:
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Nlm Unique ID: 101479935 Medline TA: Circ Cardiovasc Imaging Country: United States |
Other Details:
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Languages: eng Pagination: 424-32 Citation Subset: IM |
Affiliation:
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Departments of Cardiology and Clinical Physiology, Sahlgrenska University Hospital, Göteborg, Sweden. odd.bech-hanssen@klinfys.gu.se |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Analysis of Variance Case-Control Studies Echocardiography, Doppler / methods* Female Hemodynamics Humans Hypertension, Pulmonary / physiopathology, ultrasonography* Male Middle Aged ROC Curve Statistics, Nonparametric Tricuspid Valve Insufficiency / physiopathology, ultrasonography Vascular Resistance |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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