Accuracy and precision of three echocardiographic methods for estimating mean pulmonary artery pressure

Javier F. Aduen, Ramon Castello, John T. Daniels, Jesus A. Diaz, Robert E. Safford, Michael G. Heckman, Juliana Crook, Charles Dwayne Burger

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background: Pulmonary hypertension is defined as resting mean pulmonary artery pressure (MPAP) ≥ 25 mm Hg. MPAP pressure estimation by right-sided heart catheterization (RHC) is considered the gold standard; however, its invasiveness limits repeated and frequent use. The purpose of this study was to compare the accuracy and precision of three echocardiographic methods for estimating MPAP. Methods: We prospectively studied 117 patients with simultaneous RHC and echocardiography. MPAP was calculated by three echocardiographic methods: (1) mean gradient method(adding the right ventricular-right atrial mean systolic gradient to the right atrial pressure), (2) Chemla equation (0.61 x systolic pulmonary artery pressure + 2 mm Hg), and (3) Syyed equation (0.65 x systolic pulmonary artery pressure + 0.55 mm Hg). MPAP calculated by these three methods was compared with that obtained invasively by RHC. Results: The mean ± SD of the differences between invasive MPAP and the three echocardiographic methods were -1.6 ± 7.7 mm Hg for the mean gradient method, -3.7 ± 7.4 mm Hg for the Chemla formula, and -3.2 ± 7.6 mm Hg for the Syyed formula. Median absolute differences were 5.5 mm Hg (mean gradient), 5.7 mm Hg (Chemla;P =.45 vs mean gradient), and 6.0 mm Hg (Syyed;P =.23 vs mean gradient). Accuracy (calculated MPAP within 10 mm Hg of RHC-measured MPAP)was 81%(mean gradient), 77%(Chemla), and 76%(Syyed). Conclusions: Echocardiographic estimation of MPAP by the mean gradient method had similar accuracy and precision compared with the Chemla and Syyed methods. The acceptable accuracy of these methods suggests that they are equally suitable for clinical use.

Original languageEnglish (US)
Pages (from-to)347-352
Number of pages6
JournalChest
Volume139
Issue number2
DOIs
StatePublished - Feb 1 2011

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Pulmonary Artery
Pressure
Cardiac Catheterization
Atrial Pressure
Pulmonary Hypertension
Echocardiography

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Aduen, J. F., Castello, R., Daniels, J. T., Diaz, J. A., Safford, R. E., Heckman, M. G., ... Burger, C. D. (2011). Accuracy and precision of three echocardiographic methods for estimating mean pulmonary artery pressure. Chest, 139(2), 347-352. https://doi.org/10.1378/chest.10-0126

Accuracy and precision of three echocardiographic methods for estimating mean pulmonary artery pressure. / Aduen, Javier F.; Castello, Ramon; Daniels, John T.; Diaz, Jesus A.; Safford, Robert E.; Heckman, Michael G.; Crook, Juliana; Burger, Charles Dwayne.

In: Chest, Vol. 139, No. 2, 01.02.2011, p. 347-352.

Research output: Contribution to journalArticle

Aduen, JF, Castello, R, Daniels, JT, Diaz, JA, Safford, RE, Heckman, MG, Crook, J & Burger, CD 2011, 'Accuracy and precision of three echocardiographic methods for estimating mean pulmonary artery pressure', Chest, vol. 139, no. 2, pp. 347-352. https://doi.org/10.1378/chest.10-0126
Aduen JF, Castello R, Daniels JT, Diaz JA, Safford RE, Heckman MG et al. Accuracy and precision of three echocardiographic methods for estimating mean pulmonary artery pressure. Chest. 2011 Feb 1;139(2):347-352. https://doi.org/10.1378/chest.10-0126
Aduen, Javier F. ; Castello, Ramon ; Daniels, John T. ; Diaz, Jesus A. ; Safford, Robert E. ; Heckman, Michael G. ; Crook, Juliana ; Burger, Charles Dwayne. / Accuracy and precision of three echocardiographic methods for estimating mean pulmonary artery pressure. In: Chest. 2011 ; Vol. 139, No. 2. pp. 347-352.
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abstract = "Background: Pulmonary hypertension is defined as resting mean pulmonary artery pressure (MPAP) ≥ 25 mm Hg. MPAP pressure estimation by right-sided heart catheterization (RHC) is considered the gold standard; however, its invasiveness limits repeated and frequent use. The purpose of this study was to compare the accuracy and precision of three echocardiographic methods for estimating MPAP. Methods: We prospectively studied 117 patients with simultaneous RHC and echocardiography. MPAP was calculated by three echocardiographic methods: (1) mean gradient method(adding the right ventricular-right atrial mean systolic gradient to the right atrial pressure), (2) Chemla equation (0.61 x systolic pulmonary artery pressure + 2 mm Hg), and (3) Syyed equation (0.65 x systolic pulmonary artery pressure + 0.55 mm Hg). MPAP calculated by these three methods was compared with that obtained invasively by RHC. Results: The mean ± SD of the differences between invasive MPAP and the three echocardiographic methods were -1.6 ± 7.7 mm Hg for the mean gradient method, -3.7 ± 7.4 mm Hg for the Chemla formula, and -3.2 ± 7.6 mm Hg for the Syyed formula. Median absolute differences were 5.5 mm Hg (mean gradient), 5.7 mm Hg (Chemla;P =.45 vs mean gradient), and 6.0 mm Hg (Syyed;P =.23 vs mean gradient). Accuracy (calculated MPAP within 10 mm Hg of RHC-measured MPAP)was 81{\%}(mean gradient), 77{\%}(Chemla), and 76{\%}(Syyed). Conclusions: Echocardiographic estimation of MPAP by the mean gradient method had similar accuracy and precision compared with the Chemla and Syyed methods. The acceptable accuracy of these methods suggests that they are equally suitable for clinical use.",
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AU - Castello, Ramon

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AU - Heckman, Michael G.

AU - Crook, Juliana

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N2 - Background: Pulmonary hypertension is defined as resting mean pulmonary artery pressure (MPAP) ≥ 25 mm Hg. MPAP pressure estimation by right-sided heart catheterization (RHC) is considered the gold standard; however, its invasiveness limits repeated and frequent use. The purpose of this study was to compare the accuracy and precision of three echocardiographic methods for estimating MPAP. Methods: We prospectively studied 117 patients with simultaneous RHC and echocardiography. MPAP was calculated by three echocardiographic methods: (1) mean gradient method(adding the right ventricular-right atrial mean systolic gradient to the right atrial pressure), (2) Chemla equation (0.61 x systolic pulmonary artery pressure + 2 mm Hg), and (3) Syyed equation (0.65 x systolic pulmonary artery pressure + 0.55 mm Hg). MPAP calculated by these three methods was compared with that obtained invasively by RHC. Results: The mean ± SD of the differences between invasive MPAP and the three echocardiographic methods were -1.6 ± 7.7 mm Hg for the mean gradient method, -3.7 ± 7.4 mm Hg for the Chemla formula, and -3.2 ± 7.6 mm Hg for the Syyed formula. Median absolute differences were 5.5 mm Hg (mean gradient), 5.7 mm Hg (Chemla;P =.45 vs mean gradient), and 6.0 mm Hg (Syyed;P =.23 vs mean gradient). Accuracy (calculated MPAP within 10 mm Hg of RHC-measured MPAP)was 81%(mean gradient), 77%(Chemla), and 76%(Syyed). Conclusions: Echocardiographic estimation of MPAP by the mean gradient method had similar accuracy and precision compared with the Chemla and Syyed methods. The acceptable accuracy of these methods suggests that they are equally suitable for clinical use.

AB - Background: Pulmonary hypertension is defined as resting mean pulmonary artery pressure (MPAP) ≥ 25 mm Hg. MPAP pressure estimation by right-sided heart catheterization (RHC) is considered the gold standard; however, its invasiveness limits repeated and frequent use. The purpose of this study was to compare the accuracy and precision of three echocardiographic methods for estimating MPAP. Methods: We prospectively studied 117 patients with simultaneous RHC and echocardiography. MPAP was calculated by three echocardiographic methods: (1) mean gradient method(adding the right ventricular-right atrial mean systolic gradient to the right atrial pressure), (2) Chemla equation (0.61 x systolic pulmonary artery pressure + 2 mm Hg), and (3) Syyed equation (0.65 x systolic pulmonary artery pressure + 0.55 mm Hg). MPAP calculated by these three methods was compared with that obtained invasively by RHC. Results: The mean ± SD of the differences between invasive MPAP and the three echocardiographic methods were -1.6 ± 7.7 mm Hg for the mean gradient method, -3.7 ± 7.4 mm Hg for the Chemla formula, and -3.2 ± 7.6 mm Hg for the Syyed formula. Median absolute differences were 5.5 mm Hg (mean gradient), 5.7 mm Hg (Chemla;P =.45 vs mean gradient), and 6.0 mm Hg (Syyed;P =.23 vs mean gradient). Accuracy (calculated MPAP within 10 mm Hg of RHC-measured MPAP)was 81%(mean gradient), 77%(Chemla), and 76%(Syyed). Conclusions: Echocardiographic estimation of MPAP by the mean gradient method had similar accuracy and precision compared with the Chemla and Syyed methods. The acceptable accuracy of these methods suggests that they are equally suitable for clinical use.

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