Novo(?) método para avaliar a pressão pulmonar.

A novel method for the non-invasive estimation of mean pulmonary artery pressure by echocardiography in comparison with right heart catheter measurements





Methods: The study cohort comprised PHTN patients undergoing RHC and transthoracic echocardiograms (TTE) on the same day. Only cases with TTE studies containing “complete” TR spectral Doppler signals were included. Tracing the TR signal provided the TR mean gradient (TRMG). Right atrial pressure (RAP) was estimated based on the size and collapsibility of the inferior vena cava. The mPAP by TR (mPAP-TR) was then derived as TRMG + RAP.


Results: 100 patients (65±14 years; 86% female) were included. The mPAP on RHC was 42.5±12.4mmHg and mPAP-TR was 45.9±12.2mmHg. mPAP-TR demonstrated good agreement (Intraclass correlation 0.885) and consistency (Cronbach’s alpha 0.904) with invasive RHC measurements (See attached Bland-Altman plot demonstrating a relative mean difference of 3.44±7.26mmHg). The measurement of mPAP by this technique showed excellent test-retest reproducibility (Intra-observer variability 2±4% and inter-observer variability 2±6%


Conclusion: This novel non-invasive method for estimation of mPAP is useful in the assessment of PHTN severity. mPAP-TR is simple, reproducible, and correlates well with invasive RHC measurements.



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