Journal Article10.1111/ECHO.12779
Reliability of Doppler‐Based Measurement of Pulmonary Vascular Resistance in Congenital Heart Disease with Left‐to‐Right Shunt Lesions
Srinivas Bhyravavajhala,Vanajakshamma Velam,Nishanth V. Polapragada,Pranav Pallempati,Tammi Raju Iragavarapu,A.N. Patnaik,Seshagiri Rao Damera +6 more
9
TL;DR: In this paper, a regression equation was developed for calculation of pulmonary vascular resistance from tricuspid regurgitation velocity (TRV) and time-velocity integral of right ventricular outflow tract (TVIRVOT) by Doppler was previously shown to be a reliable noninvasive method for estimation of pulmonary arterial hypertension in acquired PAH.
read more
Abstract: Background
Pulmonary vascular resistance (PVR) is a crucial parameter in the management of patients with left-to-right shunt lesions. Cardiac catheterization (Cath) is the gold standard test to assess PVR (PVRcath), but it is invasive and hence, risky in children with pulmonary arterial hypertension (PAH). A noninvasive tool to assess PVR is desirable. Ratio of tricuspid regurgitation velocity (TRV) and time-velocity integral of right ventricular outflow tract (TVIRVOT) by Doppler was previously shown to be a reliable noninvasive method for estimation of PVR in acquired PAH.
Methods
Peak TR velocity and TVIRVOT were recorded from 63 prospective patients with various congenital shunt lesions. Subsequently, the patients were subjected to cath in less than 2 hours. The patients were subdivided into four subsets based on age and pulmonary arterial mean pressure (PAMP). A regression equation was developed for calculation of PVR from TRV/TVIRVOT (PVREcho) which was indexed for BSA (PVRIEcho). Bland–Altman analysis was done for agreement between PVRIcath and PVRIEcho. Receiver operating characteristic (ROC) curves were plotted to test the identity of the two methods and also the applicability of PVRIEcho across a wide range of Wood units.
Results
Receiver operating characteristic curve plotted between the two methods showed good identity. Bland–Altman analysis showed excellent agreement between the two methods with negligible bias. ROC curves showed that PVRIEcho was accurate in distinguishing different cutoff values of PVR in each of the 4 groups.
Conclusion
Noninvasive Doppler estimation of PVR is reliable in patients with shunt lesions over a wide range of PVR.
read more
Chat with Paper
AI Agents for this Paper
Find similar papers on Google Scholar, PubMed and Arxiv
Write a critical review of this paper
Analyze citations of this paper to find unaddressed research gaps
Citations
In the adult
Ramindar S. Dhillon,James W. Fairley +1 more
- 01 Jan 1989
TL;DR: This clinical pathway outlines the management of acute ischemic and hemorrhagic stroke patients within the Emergency Department in a multi-hospital hub and spoke model medical system.
202
Echocardiographic Screening for Pulmonary Hypertension in Congenital Heart Disease: JACC Review Topic of the Week
Konstantinos Dimopoulos,Robin Condliffe,Robert Tulloh,Paul Clift,Rafael Alonso-Gonzalez,Radwa Bedair,Natali A.Y. Chung,Gerry Coghlan,Samantha Fitzsimmons,Alessandra Frigiola,Luke S. Howard,Petra Jenkins,Damien Kenny,Wei Li,Simon T. MacDonald,Colm McCabe,James Oliver,Mark S. Spence,Gergely V. Szantho,Kate von Klemperer,D. Wilson,Stephen J. Wort +21 more
TL;DR: A systematic review and survey of experts from the United Kingdom and Ireland were performed to assess current knowledge and practice on echocardiographic screening for PH in ACHD, with particular focus on major subgroups: patients with right ventricular outflow tract obstruction, patients with systemic right ventricles, and patients with unrepaired univentricular circulation.
38
ACR Appropriateness Criteria® Known or Suspected Congenital Heart Disease in the Adult
Pamela K. Woodard,Vincent B. Ho,Scott Akers,Garth M. Beache,Richard K.J. Brown,Kristopher W. Cummings,S. Bruce Greenberg,James K. Min,Arthur E. Stillman,Jadranka Stojanovska,Jill E. Jacobs +10 more
TL;DR: Imaging procedures for the diagnosis of known or suspected CHD in the adult include chest radiography, fluoroscopy, echocardiography, nuclear scintigraphy, cardiac-gated CT, MRI, and cardiac catheterization/angiography.
12
Detección ecocardiográfica de la hipertensión pulmonar en las cardiopatías congénitas. Revisión JACC Tema de la semana
Konstantinos Dimopoulos,Robin Condliffe,Robert M.R. Tulloh,Paul Clift,Rafael Alonso-Gonzalez,Radwa Bedair,Natali A.Y. Chung,Gerry Coghlan,Samantha Fitzsimmons,Alessandra Frigiola,Luke S. Howard,Petra Jenkins,Damien Kenny,Wei Li,Simon T. MacDonald,C. McCabe,James Oliver,Mark S. Spence,Gergely Szantho,Kate von Klemperer,D. Wilson,Stephen J. Wort +21 more
- 01 Apr 2019
TL;DR: Konstantinos Dimopoulos, MD, MSc, PhD,a Robin Condliffe, MD as mentioned in this paper,b Robert M.R. Tulloh, MA, DM,c Paul Clift, MD;d Rafael Alonso-Gonzalez, MD.
1
References
Guidelines for the Echocardiographic Assessment of the Right Heart in Adults: A Report from the American Society of Echocardiography Endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography
Lawrence G. Rudski,Wyman W. Lai,Jonathan Afilalo,Lanqi Hua,Mark D. Handschumacher,Krishnaswamy Chandrasekaran,Scott D. Solomon,Eric K. Louie,Nelson B. Schiller +8 more
TL;DR: The Society of Echocardiography (SEDC) is an educational activity for cardiovascular physicians and cardiac sonographers with a knowledge base in the field of echo-cardiography as discussed by the authors.
6.2K
Guidelines for the Echocardiographic Assessment of the Right Heart in Adults: A Report from the American Society of Echocardiography
Lawrence G. Rudski,Wyman W. Lai,Jonathan Afilalo,Lanqi Hua,Mark D. Handschumacher,Krishnaswamy Chandrasekaran,Scott D. Solomon,Eric K. Louie,Nelson B. Schiller +8 more
- 01 Jan 2014
TL;DR: This activity is designed for all cardiovascular physicians and cardiac sonographers with arest and knowledge base in the field of echocardiography and reschers, clinicians, intensivists, and other medical professionals with a spein cardiac ultrasound will find this activity beneficial.
Guidelines for the diagnosis and treatment of pulmonary hypertension: the Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT)
Nazzareno Galiè,Marius M. Hoeper,Marc Humbert,Adam Torbicki,Jean-Luc Vachiery,J.A. Barberà,Maurice Beghetti,Paul A. Corris,Sean Gaine,J S R Gibbs,Miguel Ángel Gómez-Sánchez,Guillaume Jondeau,Walter Klepetko,Christian Opitz,Andrew J. Peacock,LJ Rubin,Michael J. Zellweger,Gérald Simonneau +17 more
TL;DR: In this paper, a review of the published evidence for management and/or prevention of a given condition is carried out by experts in the field and a critical evaluation of diagnostic and therapeutic procedures is performed including assessment of the risk/benefit ratio.
Guidelines for the diagnosis and treatment of pulmonary hypertension
Marius M. Hoeper,Marc Humbert,Adam Torbicki,Jean-Luc Vachiery,Joan Albert Barberà,Maurice Beghetti,Paul A. Corris,Sean Gaine,J. Simon R. Gibbs,Miguel Ángel Gómez-Sánchez,Guillaume Jondeau,Walter Klepetko,Andrew J. Peacock,Lewis J. Rubin,Michael J. Zellweger,Gérald Simonneau,Angelo Auricchio,Jeroen J. Bax,Claudio Ceconi,Veronica Dean,Gerasimos Filippatos,Christian Funck-Brentano,Richard J. Hobbs,Peter Kearney,Theresa McDonagh,Keith McGregor,Bogdan A. Popescu,Zeljko Reiner,Udo Sechtem,Michal Tendera,Panos E. Vardas,Petr Widimsky,Felicita Andreotti,Michael Aschermann,Riccardo Asteggiano,Ray Benza,Rolf M. F. Berger,Damien Bonnet,Marion Delcroix,Luke Howard,Anastasia Kitsiou,Irene Lang,Aldo P. Maggioni,Jens Erik Nielsen-Kudsk,Myung H. Park,Pasquale Perrone-Filardi,Maria Teresa Subirana Domenech,Anton Vonk-Noordegraaf,José Luis Zamorano +48 more
TL;DR: Guidelines and Expert Consensus Documents summarise and evaluate all currently available evidence on a particular issue with the aim to assist physicians in selecting the best management strategies for a typical patient, suffering from a given condition, taking into account the impact on outcome, as well as the risk/benefit ratio of particular diagnostic or therapeutic means.
1.6K
A simple method for noninvasive estimation of pulmonary vascular resistance
Amr E. Abbas,F. David Fortuin,Nelson B. Schiller,Christopher P. Appleton,Carlos A. Moreno,Steven J. Lester +5 more
TL;DR: Whether the ratio of peak tricuspid regurgitant velocity to the right ventricular outflow tract time-velocity integral obtained by Doppler echocardiography (TRV/TVI(RVOT)) provides a clinically reliable method to determine pulmonary vascular resistance (PVR) is tested.
639
Related Papers (5)
Vladislav Chubuchny,Nicola Riccardo Pugliese,Claudia Taddei,Elisa Poggianti,Valentina Spini,Andrea Barison,Bruno Formichi,Edoardo Airò,Carolina Bauleo,R. Prediletto,Luigi Emilio Pastormerlo,Michele Coceani,M. Ciardetti,Christina Petersen,Emilio Pasanisi,Carlo Lombardi,Michele Emdin,Alberto Giannoni +17 more