NYMC Faculty Publications

Can Echocardiographically Estimated Pulmonary Arterial Elastance be a Non-Invasive Predictor of Pulmonary Vascular Resistance?

Author Type(s)

Faculty

DOI

10.5114/aoms.2014.44860

Journal Title

Archives of Medical Science

First Page

692

Last Page

700

Document Type

Article

Publication Date

8-29-2014

Department

Medicine

Disciplines

Medicine and Health Sciences

Abstract

INTRODUCTION: Measurement of pulmonary vascular resistance (PVR) is essential in evaluating a patient with pulmonary hypertension.

MATERIAL AND METHODS: Data from right heart catheterization (RHC) and echocardiograms performed within 90 days of each other on 45 non-consecutive adult patients were reviewed in this retrospective study. Patients were recruited using an assortment of strategies to ensure the presence of patients with a wide range of PVR.

RESULTS: The linear regression equation between RHC-derived PVR and echocardiographic pulmonary arterial elastance (PAE) was: PVR = (562.6 × PAE) - 38.9 (R = 0.56, p < 0.0001). An adjustment for echocardiographic PAE was made by multiplying it by hemoglobin (in g/dl) and (right atrial area)(1.5) (in cm(3)). As RHC-derived PVR varies with blood hemoglobin, an adjustment for PVR was made for hemoglobin of 12 g/dl. Visualization of the XY scatter plot of adjusted PVR and adjusted PAE isolated a subset of patients with PVR higher than 8.8 Wood units, where a strong linear relationship existed (adjusted PVR = (0.89 × adjusted PAE) + 137.4, R = 0.89, p = 0.008).

CONCLUSIONS: The correlation coefficient of the regression equation connecting echocardiographic PAE and RHC-derived PVR was moderate. In a subset of patients with very high PVR and after appropriate adjustment, a strong linear relationship existed with an excellent correlation coefficient.

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