Improved Method of Doppler Estimation of Right Ventricular Systolic Pressure

Publisher Website
Google Scholar
Abstract
The right ventricular systolic pressure (RVSP) can be evaluated with the Doppler method through the right ventricular-right atrial gradient (RV-RA gradient) and the right atrial pressure. The former is expressed by the transtricuspid velocity of flow, the latter is generally assumed. In 49 patients with elevated pulmonary pressure, we tested whether ultrasounds may be utilized for the evaluation of the right atrial pressure and whether the derived values contribute to improve the accuracy of the method. We estimated the RVSP with method A: RV-RA gradient + 10 and method B: RV-RA gradient × 1.1 + 14, where 10 and 14 are the assumed right atrial pressures (mm Hg). Through the collapsibility index of the inferior vena cava, taken as an ultrasoundderived index of right atrial pressure, we were able to identify three groups of patients with normal (group 1, 14 cases), elevated (group 2, 20 cases) and moderately elevated (group 3, 15 cases) right atrial pressure, respectively. RVSP obtained with both methods (A and B) were compared to those derived with catheter. In group 1, the noninvasive values were significantly closer to the invasive ones when calculated with method A; the same was true for method B in group 2. In group 3, the accuracy of the two methods was similar. We conclude that ultrasound assists in the noninvasive approximation of the right atrial pressure as well as in the choice of the appropriate formula, so that Doppler estimation of the RVSP is improved.

This publication has 0 references indexed in Scilit: