Abstract
Critical review of Echocardiographic (Echo) predictors of pulmonary artery pressure(PA), was attempted in 37 cases who had Echos within 10 days from cardiac catheterization. Preejection period to ejection time(RVPEP/ET), time to peak velocity corrected for RVET(TPV/RVET) and negative presystolic velocity(a wave) were used. All studies were done in infants and children with 4-chamber hearts, normally related great vessels and various defects. All 3 indices correlated poorly with PA in the mixed group. The presence of the “a wave” could separate patients with PA systolic less than 30 mmHg in 30/37 cases, (“a wave” indistinguishable in 4 cases, 3 false estimates)
RVTPV/ET less than .35 could separate patients with PA systolic over 30 mmHg if cases with a pulmonic gradient more than 20 mmHg were excluded and RV outflow measurements were used in patients with patent ductus arteriosus (Technical estimation impossible in 5 cases). RVPEP/ET more than .35 could separate cases with PA systolic over 30 mmHg. (Technical estimation impossible in 5 cases, 6 false estimates).
We conclude that there are both technical problems and limitations in the application of all used indices for the non invasive prediction of pulmonary hypertension in congenital heart disease.
Invasive estimation of PA pressure is imperative in cases under question.
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Sideris, E., Sideris, S. & Jones, J. 141 ECHOCARDIOGRAPHIC PREDICTORS OF PULMONARY HYPERTENSION IN CONGENITAL HEART DISEASE. Pediatr Res 19, 134 (1985). https://doi.org/10.1203/00006450-198504000-00171
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DOI: https://doi.org/10.1203/00006450-198504000-00171
