- Title
- Echocardiographic determination of pulmonary arterial capacitance
- Creator
- Papolos, Alexander; Fan, Eugene; Tison, Geoffrey H.; Wagle, Rohan R.; Foster, Elyse; Boyle, Andrew J.; Yeghiazarians, Yerem; MacGregor, John S.; Grossman, William; Schiller, Nelson B.; Ganz, Peter
- Relation
- International Journal of Cardiovascular Imaging Vol. 35, p. 1581-1586
- Publisher Link
- http://dx.doi.org/10.1007/s10554-019-01595-9
- Publisher
- Springer
- Resource Type
- journal article
- Date
- 2019
- Description
- A growing body of evidence has demonstrated that pulmonary arterial capacitance (PAC) is the strongest hemodynamic predictor of clinical outcomes across a wide spectrum of cardiovascular disease, including pulmonary hypertension and heart failure. We hypothesized that a ratio of right ventricular stroke volume (RVOT VTI) to the associated peak arterial systolic pressure (PASP) could function as a reliable non-invasive surrogate for PAC. We performed a prospective study of patients undergoing simultaneous transthoracic echocardiography and right heart catheterization (RHC) for various clinical indications. Measurements of the RVOT VTI/PASP ratio from echocardiographic measurements were compared against PAC calculated from RHC measurements. Correlation coefficients and Bland-Altman analysis compared the RVOT VTI/PASP ratio with PAC. Forty-five subjects were enrolled, 38% were female and mean age was 54 years (SD 13 years). The reason for referral to RHC was most commonly post-heart transplant surveillance (40%), followed by heart failure (22%), and pulmonary hypertension (18%). Pre-capillary pulmonary hypertension was present in 18%, isolated post-capillary pulmonary hypertension was present in 13%, and combined pre-and post-capillary pulmonary hypertension was present in 29%. The RVOT VTI/PASP ratio was obtainable in the majority of patients (78%), and Pearson's correlation demonstrated moderately-strong association between PAC and the RVOT VTI/PASP ratio, r = 0.75 (P < 0.001). Bland-Altman analysis demonstrated good agreement between measurements without suggestion of systematic bias and a mean difference in standardized units of - 0.133. In a diverse population of patients and hemodynamic profiles, we validated that the ratio of RVOT VTI/PASP to be a reliably-obtained non-invasive marker associated with PAC.
- Subject
- pulmonary hypertension; heart failure; echocardiography; imaging and diagnostics
- Identifier
- http://hdl.handle.net/1959.13/1424588
- Identifier
- uon:38110
- Identifier
- ISSN:1569-5794
- Language
- eng
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