Pressão pulmonar ao ecocardiograma

A pulmonary regurgitation (PR) signal is obtained in the parasternal short axis view using colour Doppler. CW Doppler at a sweep speed of 100 mm/s is used to measure the peak PR velocity (Fig. 3). Peak pressure difference (measured by the Bernoulli equation) is then added to the RAP. This method has been validated against gold standard catheter-measurements [13][14].

Mean PAP can be approximated from the peak PR Doppler signal using the following formula: mPAP = 4(PRpeak velocity)2 + RAP.


mPAP = 2/3rd of PADP + 1/3rd of PASP.

Válvula ou Pulmão?

Stress Echocardiography

The clinical indications for stress echocardiography (SE) in the context of PH-LHD are as follows: severe VHD without symptoms, non-severe VHD with symptoms, and symptomatic non-severe VHD with low flow . Heart rate normally increases two- to three-fold during exercise, contractility three- to four-fold, and systolic blood pressure by ≥ 50%, while systemic vascular resistance decreases. This often serves to reveal symptoms in patients previously considered asymptomatic or, for example, may demonstrate that mitral valve stenosis changes from moderate to severe with activity.

Therefore, SE may be a useful diagnostic tool in selected cases of suspected PH-LHD (pulmonary hypertension related to left heart disease ) leading to recommendations to treat the underlying VHD.