A simple method for noninvasive estimation of pulmonary vascular resistance

Amr E. Abbas, F. David Fortuin, Nelson B. Schiller, Christopher P. Appleton, Carlos A. Moreno, Steven Jay Lester

Research output: Contribution to journalArticle

400 Citations (Scopus)

Abstract

OBJECTIVES: We sought to test whether the ratio of peak tricuspid regurgitant velocity (TRV, ms) to the right ventricular outflow tract time-velocity integral (TVIRVOT, cm) obtained by Doppler echocardiography (TRV/TVIRVOT) provides a clinically reliable method to determine pulmonary vascular resistance (PVR). BACKGROUND: Pulmonary vascular resistance is an important hemodynamic variable used in the management of patients with cardiovascular and pulmonary disease. Right-heart catheterization, with its associated disadvantages, is required to determine PVR. However, a reliable noninvasive method is unavailable. METHODS: Simultaneous Doppler echocardiographic examination and right-heart catheterization were performed in 44 patients. The ratio of TRV/TVIRVOT was then correlated with invasive PVR measurements using regression analysis. An equation was modeled to calculate PVR in Wood units (WU) using echocardiography, and the results were compared with invasive PVR measurements using the Bland-Altman analysis. Using receiver-operating characteristics curve analysis, a cutoff value for the Doppler equation was generated to determine PVR >2WU. RESULTS: As calculated by Doppler echocardiography, TRV/TVIRVOT correlated well (r = 0.929, 95% confidence interval 0.87 to 0.96) with invasive PVR measurements. The Bland-Altman analysis between PVR obtained invasively and that by echocardiography, using the equation: PVR = TRV/TVIRVOT × 10 + 0.16, showed satisfactory limits of agreement (mean 0 ± 0.41). A TRV/TVIRVOT cutoff value of 0.175 had a sensitivity of 77% and a specificity of 81% to determine PVR >2WU. CONCLUSIONS: Doppler echocardiography may provide a reliable, noninvasive method to determine PVR.

Original languageEnglish (US)
Pages (from-to)1021-1027
Number of pages7
JournalJournal of the American College of Cardiology
Volume41
Issue number6
DOIs
StatePublished - Mar 19 2003

Fingerprint

Vascular Resistance
Doppler Echocardiography
Cardiac Catheterization
Echocardiography
ROC Curve
Lung Diseases
Cardiovascular Diseases
Hemodynamics
Regression Analysis
Confidence Intervals

ASJC Scopus subject areas

  • Nursing(all)

Cite this

A simple method for noninvasive estimation of pulmonary vascular resistance. / Abbas, Amr E.; Fortuin, F. David; Schiller, Nelson B.; Appleton, Christopher P.; Moreno, Carlos A.; Lester, Steven Jay.

In: Journal of the American College of Cardiology, Vol. 41, No. 6, 19.03.2003, p. 1021-1027.

Research output: Contribution to journalArticle

Abbas, Amr E. ; Fortuin, F. David ; Schiller, Nelson B. ; Appleton, Christopher P. ; Moreno, Carlos A. ; Lester, Steven Jay. / A simple method for noninvasive estimation of pulmonary vascular resistance. In: Journal of the American College of Cardiology. 2003 ; Vol. 41, No. 6. pp. 1021-1027.
@article{95cd7a9e3af140b49bf436ac4b66a05d,
title = "A simple method for noninvasive estimation of pulmonary vascular resistance",
abstract = "OBJECTIVES: We sought to test whether the ratio of peak tricuspid regurgitant velocity (TRV, ms) to the right ventricular outflow tract time-velocity integral (TVIRVOT, cm) obtained by Doppler echocardiography (TRV/TVIRVOT) provides a clinically reliable method to determine pulmonary vascular resistance (PVR). BACKGROUND: Pulmonary vascular resistance is an important hemodynamic variable used in the management of patients with cardiovascular and pulmonary disease. Right-heart catheterization, with its associated disadvantages, is required to determine PVR. However, a reliable noninvasive method is unavailable. METHODS: Simultaneous Doppler echocardiographic examination and right-heart catheterization were performed in 44 patients. The ratio of TRV/TVIRVOT was then correlated with invasive PVR measurements using regression analysis. An equation was modeled to calculate PVR in Wood units (WU) using echocardiography, and the results were compared with invasive PVR measurements using the Bland-Altman analysis. Using receiver-operating characteristics curve analysis, a cutoff value for the Doppler equation was generated to determine PVR >2WU. RESULTS: As calculated by Doppler echocardiography, TRV/TVIRVOT correlated well (r = 0.929, 95{\%} confidence interval 0.87 to 0.96) with invasive PVR measurements. The Bland-Altman analysis between PVR obtained invasively and that by echocardiography, using the equation: PVR = TRV/TVIRVOT × 10 + 0.16, showed satisfactory limits of agreement (mean 0 ± 0.41). A TRV/TVIRVOT cutoff value of 0.175 had a sensitivity of 77{\%} and a specificity of 81{\%} to determine PVR >2WU. CONCLUSIONS: Doppler echocardiography may provide a reliable, noninvasive method to determine PVR.",
author = "Abbas, {Amr E.} and Fortuin, {F. David} and Schiller, {Nelson B.} and Appleton, {Christopher P.} and Moreno, {Carlos A.} and Lester, {Steven Jay}",
year = "2003",
month = "3",
day = "19",
doi = "10.1016/S0735-1097(02)02973-X",
language = "English (US)",
volume = "41",
pages = "1021--1027",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "6",

}

TY - JOUR

T1 - A simple method for noninvasive estimation of pulmonary vascular resistance

AU - Abbas, Amr E.

AU - Fortuin, F. David

AU - Schiller, Nelson B.

AU - Appleton, Christopher P.

AU - Moreno, Carlos A.

AU - Lester, Steven Jay

PY - 2003/3/19

Y1 - 2003/3/19

N2 - OBJECTIVES: We sought to test whether the ratio of peak tricuspid regurgitant velocity (TRV, ms) to the right ventricular outflow tract time-velocity integral (TVIRVOT, cm) obtained by Doppler echocardiography (TRV/TVIRVOT) provides a clinically reliable method to determine pulmonary vascular resistance (PVR). BACKGROUND: Pulmonary vascular resistance is an important hemodynamic variable used in the management of patients with cardiovascular and pulmonary disease. Right-heart catheterization, with its associated disadvantages, is required to determine PVR. However, a reliable noninvasive method is unavailable. METHODS: Simultaneous Doppler echocardiographic examination and right-heart catheterization were performed in 44 patients. The ratio of TRV/TVIRVOT was then correlated with invasive PVR measurements using regression analysis. An equation was modeled to calculate PVR in Wood units (WU) using echocardiography, and the results were compared with invasive PVR measurements using the Bland-Altman analysis. Using receiver-operating characteristics curve analysis, a cutoff value for the Doppler equation was generated to determine PVR >2WU. RESULTS: As calculated by Doppler echocardiography, TRV/TVIRVOT correlated well (r = 0.929, 95% confidence interval 0.87 to 0.96) with invasive PVR measurements. The Bland-Altman analysis between PVR obtained invasively and that by echocardiography, using the equation: PVR = TRV/TVIRVOT × 10 + 0.16, showed satisfactory limits of agreement (mean 0 ± 0.41). A TRV/TVIRVOT cutoff value of 0.175 had a sensitivity of 77% and a specificity of 81% to determine PVR >2WU. CONCLUSIONS: Doppler echocardiography may provide a reliable, noninvasive method to determine PVR.

AB - OBJECTIVES: We sought to test whether the ratio of peak tricuspid regurgitant velocity (TRV, ms) to the right ventricular outflow tract time-velocity integral (TVIRVOT, cm) obtained by Doppler echocardiography (TRV/TVIRVOT) provides a clinically reliable method to determine pulmonary vascular resistance (PVR). BACKGROUND: Pulmonary vascular resistance is an important hemodynamic variable used in the management of patients with cardiovascular and pulmonary disease. Right-heart catheterization, with its associated disadvantages, is required to determine PVR. However, a reliable noninvasive method is unavailable. METHODS: Simultaneous Doppler echocardiographic examination and right-heart catheterization were performed in 44 patients. The ratio of TRV/TVIRVOT was then correlated with invasive PVR measurements using regression analysis. An equation was modeled to calculate PVR in Wood units (WU) using echocardiography, and the results were compared with invasive PVR measurements using the Bland-Altman analysis. Using receiver-operating characteristics curve analysis, a cutoff value for the Doppler equation was generated to determine PVR >2WU. RESULTS: As calculated by Doppler echocardiography, TRV/TVIRVOT correlated well (r = 0.929, 95% confidence interval 0.87 to 0.96) with invasive PVR measurements. The Bland-Altman analysis between PVR obtained invasively and that by echocardiography, using the equation: PVR = TRV/TVIRVOT × 10 + 0.16, showed satisfactory limits of agreement (mean 0 ± 0.41). A TRV/TVIRVOT cutoff value of 0.175 had a sensitivity of 77% and a specificity of 81% to determine PVR >2WU. CONCLUSIONS: Doppler echocardiography may provide a reliable, noninvasive method to determine PVR.

UR - http://www.scopus.com/inward/record.url?scp=0037454142&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037454142&partnerID=8YFLogxK

U2 - 10.1016/S0735-1097(02)02973-X

DO - 10.1016/S0735-1097(02)02973-X

M3 - Article

C2 - 12651052

AN - SCOPUS:0037454142

VL - 41

SP - 1021

EP - 1027

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 6

ER -