Clinical lung and heart/lung transplantationPulmonary artery systolic pressures estimated by echocardiogram vs cardiac catheterization in patients awaiting lung transplantation☆
Section snippets
Patient selection
At the time of the study, 119 patients with end-stage vascular or parenchymal pulmonary disease were transplanted or on the waiting list in our lung transplantation program. Recipient criteria and surgical techniques have been previously described.14 All patients received right heart catheterization and transthoracic Doppler echocardiography as part of the pre-transplant evaluation.
Patients with PH as assessed by right heart catheterization who had a Doppler echocardiographic study performed
Results
We reviewed the charts of 119 consecutive patients listed or transplanted for end-stage vascular and parenchymal lung disease by May 15, 1996. This group comprised 29 patients with pulmonary fibrosis (PF); 37 patients with tobacco-related chronic obstructive pulmonary disease (COPD); 29 patients with α1-antitrypsin deficiency-related COPD; 10 patients with primary pulmonary hypertension (PPH); 7 patients with sarcoidosis; 2 patients with scleroderma; and 1 patient each with rheumatoid
Discussion
Using echocardiogram to calculate PAS by measuring the regurgitant jet across the tricuspid valve has been extensively described; however, in these series only 5% to 14% of the patients had vascular or parenchymal lung disease.10, 11, 18 Our group previously described the use of echocardiogram to evaluate the right ventricular structure and function before and after lung transplantation.17 In the initial series, the echocardiogram could not estimate the PAS pressure in 38% of the patients with
Acknowledgements
We want to thank Michael F. Luther, MS, for his help in the statistical analysis of the data.
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Cited by (74)
Detection of Pulmonary Hypertension by Combining Echocardiography and Chest Radiography
2022, Academic RadiologyCitation Excerpt :The diagnosis depends on pulmonary artery pressure, which is invasively measured by right heart catheterization (RHC) (3). Echocardiography is extensively used as an initial screening and diagnostic test, but its accuracy as a single examination is not high enough for the diagnosis or exclusion of PH (4–6). Chest radiography, as a noninvasive examination, is routinely performed in patients with an underlying heart or lung disease who may be at risk of PH. The normal diameter of the right descending pulmonary artery on X-ray images ranges from 10 to 16 mm (7).
Non-invasive screening for pulmonary hypertension in idiopathic pulmonary fibrosis
2016, Respiratory MedicineAccuracy of Doppler echocardiographic estimates of pulmonary artery pressures in a canine model of pulmonary hypertension
2015, Journal of Veterinary CardiologyCitation Excerpt :In evaluating the relationship between peak TR gradient and sPAPRHC, noninvasive estimates of PAP appear to have increased variance when PAP is higher. Our results are in agreement with many studies in human patients with PH. Several investigators have reported that using peak TR gradients as surrogates for invasive sPAPRHC measurements is prone to inaccuracy, both for the diagnosis of PH and for classifying its severity,11,17–21 and another study identified no significant correlation between peak or end-diastolic PR gradients and mPAPRHC or dPAPRHC, respectively.37 Also similar to what has been reported in human patients, we observed both under and overestimation of actual PAPRHC in this study, with a tendency towards underestimation when using ECHO.17,18,21
Role of BNP and echo measurement for pulmonary hypertension recognition in patients with interstitial lung disease: An algorithm application model
2015, Respiratory MedicineCitation Excerpt :However the optimal diagnostic algorithm to assess PH in ILD remains to be elucidated; currently, the most common methods is trans-thoracic echocardiography showing a good correlation with invasive measurement. Nevertheless, in some patients it cannot be performed because poor acoustic window and awkwardness to detect a reliable PAP measurement [13,14]; therefore the prognostic value of Echocardiography, in patients awaiting lung transplantation has been debated because of a mild correlation with RHC measurement [15]. Accordingly whit these findings, we suppose that the combination of pulmonary function tests, echocardiography and BNP could be useful for a foremost recognition of PH in patients with ILD.
Estimation of pulmonary pressures and diagnosis of pulmonary hypertension by doppler echocardiography: A retrospective comparison of routine echocardiography and invasive hemodynamics
2013, Journal of the American Society of Echocardiography
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