Background Transthoracic Doppler echocardiography is recommended for screening the presence of pulmonary hypertension(PH).However,the accuracy of pulmonary artery systolic pressure(PASP) estimated by Doppler echocardi...Background Transthoracic Doppler echocardiography is recommended for screening the presence of pulmonary hypertension(PH).However,the accuracy of pulmonary artery systolic pressure(PASP) estimated by Doppler echocardiographic is still unknown.Methods We conducted a retrospective study on 102 patients with idiopathic pulmonary arterial hypertension who underwent Doppler echocar-diography within 72 hours before right heart catheterization. During this time,all patients were stable without any specific drug therapy.Results There was moderate correlation between Doppler echocardiographic and right heart catheteriza- tion measurements of PASP(r =0.642,P【0.001).Using Bland-Altman analytic methods,the bias for the echocardio-graphic estimates of PASP was 6.65 mm Hg with 95%limits of agreement ranging from -47.62 to 34.30 mm Hg.There were 58.8%cases with absolute differences over 10 mm Hg between the two methods.Overestimation and underestimation of PASP by Doppler echocardiography occurred in 15.7% (16/102) and 43.1%(44),respectively.The magnitude of pressure underestimation and overestimation was insignificant (24.52±12.15 vs.25.69±16.09,P=0.765),while the corresponding diagnostic categories of severity that each subject would fall into for each technique are not in good agreement. The diagnostic categories of 16 overestimated patients were in accordance.During 44 underestimated patients,20.5%of patients had their pressure underestimated within one diagnostic category(minor error);4.5%of the underestimates were with two diagnostic categories(major error).Conclusions Transthoracic Doppler echocardiography may frequently be inaccurate in estimating PASP and could not replace the right heart catheterization.展开更多
文摘Background Transthoracic Doppler echocardiography is recommended for screening the presence of pulmonary hypertension(PH).However,the accuracy of pulmonary artery systolic pressure(PASP) estimated by Doppler echocardiographic is still unknown.Methods We conducted a retrospective study on 102 patients with idiopathic pulmonary arterial hypertension who underwent Doppler echocar-diography within 72 hours before right heart catheterization. During this time,all patients were stable without any specific drug therapy.Results There was moderate correlation between Doppler echocardiographic and right heart catheteriza- tion measurements of PASP(r =0.642,P【0.001).Using Bland-Altman analytic methods,the bias for the echocardio-graphic estimates of PASP was 6.65 mm Hg with 95%limits of agreement ranging from -47.62 to 34.30 mm Hg.There were 58.8%cases with absolute differences over 10 mm Hg between the two methods.Overestimation and underestimation of PASP by Doppler echocardiography occurred in 15.7% (16/102) and 43.1%(44),respectively.The magnitude of pressure underestimation and overestimation was insignificant (24.52±12.15 vs.25.69±16.09,P=0.765),while the corresponding diagnostic categories of severity that each subject would fall into for each technique are not in good agreement. The diagnostic categories of 16 overestimated patients were in accordance.During 44 underestimated patients,20.5%of patients had their pressure underestimated within one diagnostic category(minor error);4.5%of the underestimates were with two diagnostic categories(major error).Conclusions Transthoracic Doppler echocardiography may frequently be inaccurate in estimating PASP and could not replace the right heart catheterization.
