Document Detail

Noninvasive evaluation of pulmonary artery pressure during exercise by saline-enhanced Doppler echocardiography in chronic pulmonary disease.
MedLine Citation:
PMID:  2924417     Owner:  NLM     Status:  MEDLINE    
To determine the feasibility of noninvasive determination of right ventricular systolic pressure (RVSP) during a graded-exercise protocol, saline contrast-enhanced Doppler echocardiography of tricuspid insufficiency was performed in 36 patients with chronic lung disease and 12 normal controls. In the patients with chronic pulmonary disease, symptom-limited, incremental supine bicycle exercise and pulse oximetry were performed on and off high-flow oxygen. Technically adequate Doppler studies were initially obtained in 20 patients (56%) at rest and 14 (39%) on exercise; these numbers increased to 33 (92%) and 32 (89%), respectively, after enhancement with agitated saline (both p less than 0.001). In 10 patients with chronic lung disease who had simultaneous hemodynamic monitoring during exercise, the correlation between Doppler and catheter measurements of pulmonary artery systolic pressure was close (r = 0.98). Among controls, RVSP increased from 22 +/- 4 at rest (mean +/- SD) to 31 +/- 7 mm Hg at peak exercise. In patients with chronic lung disease, RVSP increased from 46 +/- 20 to 83 +/- 30 mm Hg (both p less than 0.001 vs. controls). Despite normal resting values for RVSP in 28% of study patients, nearly all showed abnormal increases in RVSP during supine bicycle exercise. Increases in RVSP during exercise were greatest in patients who showed oxyhemoglobin desaturation. The short-term administration of oxygen significantly blunted the increase in RVSP during exercise. Saline contrast-enhanced Doppler evaluation of tricuspid insufficiency seems a potentially valuable noninvasive method of determining the exercise response of RVSP in patients with chronic pulmonary disease.
R B Himelman; M Stulbarg; B Kircher; E Lee; L Kee; N C Dean; J Golden; C L Wolfe; N B Schiller
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Circulation     Volume:  79     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1989 Apr 
Date Detail:
Created Date:  1989-05-05     Completed Date:  1989-05-05     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  863-71     Citation Subset:  AIM; IM    
Department of Medicine, University of California, San Francisco.
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MeSH Terms
Aged, 80 and over
Blood Pressure
Echocardiography, Doppler*
Exercise Test
Hypertension, Pulmonary / diagnosis*
Lung Diseases, Obstructive / physiopathology*
Middle Aged
Oxyhemoglobins / metabolism
Pulmonary Artery / physiopathology*
Sodium Chloride / diagnostic use
Tricuspid Valve Insufficiency / diagnosis*
Grant Support
Reg. No./Substance:
0/Oxyhemoglobins; 7647-14-5/Sodium Chloride

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

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