Document Detail

Noninvasive Doppler tissue measurement of pulmonary artery compliance in children with pulmonary hypertension.
MedLine Citation:
PMID:  16581479     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: We have shown previously that input impedance of the pulmonary vasculature provides a comprehensive characterization of right ventricular afterload by including compliance. However, impedance-based compliance assessment requires invasive measurements. Here, we develop and validate a noninvasive method to measure pulmonary artery (PA) compliance using ultrasound color M-mode (CMM) Doppler tissue imaging (DTI).
METHODS: Dynamic compliance (C(dyn)) of the PA was obtained from CMM DTI and continuous wave Doppler measurement of the tricuspid regurgitant velocity. C(dyn) was calculated as: [(D(s) - D(d))/(D(d) x P(s))] x 10(4); where D(s) = systolic diameter, D(d) = diastolic diameter, and P(s) = systolic pressure. The method was validated both in vitro and in 13 patients in the catheterization laboratory, and then tested on 27 pediatric patients with pulmonary hypertension, with comparison with 10 age-matched control subjects. C(dyn) was also measured in an additional 13 patients undergoing reactivity studies.
RESULTS: Instantaneous diameter measured using CMM DTI agreed well with intravascular ultrasound measurements in the in vitro models. Clinically, C(dyn) calculated by CMM DTI agreed with C(dyn) calculated using invasive techniques (23.4 +/- 16.8 vs 29.1 +/- 20.6%/100 mm Hg; P = not significant). Patients with pulmonary hypertension had significantly lower peak wall velocity values and lower C(dyn) values than control subjects (P < .01). C(dyn) values followed an exponentially decaying relationship with PA pressure, indicating the nonlinear stress-strain behavior of these arteries. Reactivity in C(dyn) agreed with reactivity measured using impedance techniques.
CONCLUSION: The C(dyn) method provides a noninvasive means of assessing PA compliance and should be useful as an additional measure of vascular reactivity subsequent to pulmonary vascular resistance in patients with pulmonary hypertension.
Karrie Dyer; Craig Lanning; Bibhuti Das; Po-Feng Lee; D Dunbar Ivy; Lilliam Valdes-Cruz; Robin Shandas
Related Documents :
16338149 - Long-term monitoring of pulmonary arterial pressure in conscious, unrestrained mice.
8880239 - Response to nitric oxide inhalation in early acute lung injury.
11279379 - Norepinephrine can be useful for the treatment of right ventricular failure combined wi...
20118039 - Closure of a large patent ductus arteriosus in children and adults with pulmonary hyper...
8004529 - Percutaneous balloon valvuloplasty for congenital critical pulmonary stenosis in neonates.
9681789 - Recovery from circulatory shock in severe primary pulmonary hypertension (pph) with aer...
12020489 - Neurohormonal activation rapidly decreases after intravenous therapy with diuretics and...
17307999 - Effects of hypertension on cardiovascular responses to epinephrine in humans.
15683589 - Hypertension, stroke, and endothelium.
Publication Detail:
Type:  Controlled Clinical Trial; Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  19     ISSN:  1097-6795     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-04-03     Completed Date:  2006-05-02     Revised Date:  2014-09-08    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  403-12     Citation Subset:  IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Child, Preschool
Echocardiography, Doppler / methods*
Hypertension, Pulmonary / complications,  physiopathology,  ultrasonography*
Image Interpretation, Computer-Assisted / methods*
Pulmonary Artery / physiopathology,  ultrasonography*
Ventricular Dysfunction, Left / etiology,  physiopathology,  ultrasonography*
Grant Support

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

Previous Document:  Three-dimensional tricuspid annular function provides insight into the mechanisms of tricuspid valve...
Next Document:  Use of real-time 3-dimensional transthoracic echocardiography in the evaluation of mitral valve dise...