A novel echocardiographic method for estimation of pulmonary artery wedge pressure and pulmonary vascular resistance
Abstract Aims This study aimed to evaluate a novel echocardiographic algorithm for quantitative estimation of pulmonary artery wedge pressure (PAWP) and pulmonary vascular resistance (PVR) in patients with heart failure and pulmonary hypertension (PH) scheduled to right heart catheterization (RHC)....
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-04-01
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| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.13183 |
| _version_ | 1818619211604295680 |
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| author | Vladislav Chubuchny Nicola Riccardo Pugliese Claudia Taddei Elisa Poggianti Valentina Spini Andrea Barison Bruno Formichi Edoardo Airò Carolina Bauleo Renato Prediletto Luigi Emilio Pastormerlo Michele Coceani Marco Ciardetti Christina Petersen Emilio Pasanisi Carlo Lombardi Michele Emdin Alberto Giannoni |
| author_facet | Vladislav Chubuchny Nicola Riccardo Pugliese Claudia Taddei Elisa Poggianti Valentina Spini Andrea Barison Bruno Formichi Edoardo Airò Carolina Bauleo Renato Prediletto Luigi Emilio Pastormerlo Michele Coceani Marco Ciardetti Christina Petersen Emilio Pasanisi Carlo Lombardi Michele Emdin Alberto Giannoni |
| author_sort | Vladislav Chubuchny |
| collection | DOAJ |
| description | Abstract Aims This study aimed to evaluate a novel echocardiographic algorithm for quantitative estimation of pulmonary artery wedge pressure (PAWP) and pulmonary vascular resistance (PVR) in patients with heart failure and pulmonary hypertension (PH) scheduled to right heart catheterization (RHC). Methods and results In this monocentric study, 795 consecutive patients (427 men; age 68.4 ± 12.1 years) undergoing echocardiography and RHC were evaluated. Multiple regression analysis was performed to identify echocardiographic predictors of PAWP and PVR measured by RHC in the derivation group (the first 200 patients). The diagnostic accuracy of the model was then tested in the validation group (the remaining 595 patients). PH was confirmed by RHC in 507 (63.8%) patients, with 192 (24.2%) cases of precapillary PH, 248 (31.2%) of postcapillary PH, and 67 (8.4%) of combined PH. At regression analysis, tricuspid regurgitation maximal velocity, mitral E/e′ ratio, left ventricular ejection fraction, right ventricular fractional area change, inferior vena cava diameter, and left atrial volume index were included in the model (R = 0.8, P < 0.001). The model showed a high diagnostic accuracy in estimating elevated PAWP (area under the receiver operating characteristic curve = 0.97, 92% sensitivity, and 93% specificity, P < 0.001) and PVR (area under the receiver operating characteristic curve = 0.96, 89% sensitivity, and 92% specificity, P < 0.001), outperforming 2016 American Society of Echocardiography/European Association of Cardiovascular Imaging recommendations (P < 0.001) and Abbas' equation (P < 0.001). Bland–Altman analysis showed satisfactory limits of agreement between echocardiography and RHC for PAWP (bias 0.7, 95% confidence interval −7.3 to 8.7) and PVR (bias −0.1, 95% confidence interval −2.2 to 1.9 Wood units), without indeterminate cases. Conclusions A novel quantitative echocardiographic approach for the estimation of PAWP and PVR has high diagnostic accuracy in patients with heart failure and PH. |
| first_indexed | 2024-12-16T17:33:53Z |
| format | Article |
| id | doaj.art-2dac804df0a247d98862f7538a0f336a |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-12-16T17:33:53Z |
| publishDate | 2021-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-2dac804df0a247d98862f7538a0f336a2022-12-21T22:22:51ZengWileyESC Heart Failure2055-58222021-04-01821216122910.1002/ehf2.13183A novel echocardiographic method for estimation of pulmonary artery wedge pressure and pulmonary vascular resistanceVladislav Chubuchny0Nicola Riccardo Pugliese1Claudia Taddei2Elisa Poggianti3Valentina Spini4Andrea Barison5Bruno Formichi6Edoardo Airò7Carolina Bauleo8Renato Prediletto9Luigi Emilio Pastormerlo10Michele Coceani11Marco Ciardetti12Christina Petersen13Emilio Pasanisi14Carlo Lombardi15Michele Emdin16Alberto Giannoni17Cardiology and Cardiovascular Medicine Department Fondazione Toscana G. Monasterio Pisa ItalyCardiothoracic and Vascular Department University Hospital of Pisa Pisa ItalyCardiology and Cardiovascular Medicine Department Fondazione Toscana G. Monasterio Pisa ItalyCardiology and Cardiovascular Medicine Department Fondazione Toscana G. Monasterio Pisa ItalyCardiology and Cardiovascular Medicine Department Fondazione Toscana G. Monasterio Pisa ItalyCardiology and Cardiovascular Medicine Department Fondazione Toscana G. Monasterio Pisa ItalyCardiology and Cardiovascular Medicine Department Fondazione Toscana G. Monasterio Pisa ItalyCardiology and Cardiovascular Medicine Department Fondazione Toscana G. Monasterio Pisa ItalyCardiology and Cardiovascular Medicine Department Fondazione Toscana G. Monasterio Pisa ItalyCardiology and Cardiovascular Medicine Department Fondazione Toscana G. Monasterio Pisa ItalyCardiology and Cardiovascular Medicine Department Fondazione Toscana G. Monasterio Pisa ItalyCardiology and Cardiovascular Medicine Department Fondazione Toscana G. Monasterio Pisa ItalyCardiology and Cardiovascular Medicine Department Fondazione Toscana G. Monasterio Pisa ItalyCardiology and Cardiovascular Medicine Department Fondazione Toscana G. Monasterio Pisa ItalyCardiology and Cardiovascular Medicine Department Fondazione Toscana G. Monasterio Pisa ItalyInstitute of Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialities, Radiological Sciences and Public Health University of Brescia Brescia ItalyCardiology and Cardiovascular Medicine Department Fondazione Toscana G. Monasterio Pisa ItalyCardiology and Cardiovascular Medicine Department Fondazione Toscana G. Monasterio Pisa ItalyAbstract Aims This study aimed to evaluate a novel echocardiographic algorithm for quantitative estimation of pulmonary artery wedge pressure (PAWP) and pulmonary vascular resistance (PVR) in patients with heart failure and pulmonary hypertension (PH) scheduled to right heart catheterization (RHC). Methods and results In this monocentric study, 795 consecutive patients (427 men; age 68.4 ± 12.1 years) undergoing echocardiography and RHC were evaluated. Multiple regression analysis was performed to identify echocardiographic predictors of PAWP and PVR measured by RHC in the derivation group (the first 200 patients). The diagnostic accuracy of the model was then tested in the validation group (the remaining 595 patients). PH was confirmed by RHC in 507 (63.8%) patients, with 192 (24.2%) cases of precapillary PH, 248 (31.2%) of postcapillary PH, and 67 (8.4%) of combined PH. At regression analysis, tricuspid regurgitation maximal velocity, mitral E/e′ ratio, left ventricular ejection fraction, right ventricular fractional area change, inferior vena cava diameter, and left atrial volume index were included in the model (R = 0.8, P < 0.001). The model showed a high diagnostic accuracy in estimating elevated PAWP (area under the receiver operating characteristic curve = 0.97, 92% sensitivity, and 93% specificity, P < 0.001) and PVR (area under the receiver operating characteristic curve = 0.96, 89% sensitivity, and 92% specificity, P < 0.001), outperforming 2016 American Society of Echocardiography/European Association of Cardiovascular Imaging recommendations (P < 0.001) and Abbas' equation (P < 0.001). Bland–Altman analysis showed satisfactory limits of agreement between echocardiography and RHC for PAWP (bias 0.7, 95% confidence interval −7.3 to 8.7) and PVR (bias −0.1, 95% confidence interval −2.2 to 1.9 Wood units), without indeterminate cases. Conclusions A novel quantitative echocardiographic approach for the estimation of PAWP and PVR has high diagnostic accuracy in patients with heart failure and PH.https://doi.org/10.1002/ehf2.13183EchocardiographyPulmonary artery wedge pressurePulmonary vascular resistancePulmonary hypertensionRight heart catheterization |
| spellingShingle | Vladislav Chubuchny Nicola Riccardo Pugliese Claudia Taddei Elisa Poggianti Valentina Spini Andrea Barison Bruno Formichi Edoardo Airò Carolina Bauleo Renato Prediletto Luigi Emilio Pastormerlo Michele Coceani Marco Ciardetti Christina Petersen Emilio Pasanisi Carlo Lombardi Michele Emdin Alberto Giannoni A novel echocardiographic method for estimation of pulmonary artery wedge pressure and pulmonary vascular resistance ESC Heart Failure Echocardiography Pulmonary artery wedge pressure Pulmonary vascular resistance Pulmonary hypertension Right heart catheterization |
| title | A novel echocardiographic method for estimation of pulmonary artery wedge pressure and pulmonary vascular resistance |
| title_full | A novel echocardiographic method for estimation of pulmonary artery wedge pressure and pulmonary vascular resistance |
| title_fullStr | A novel echocardiographic method for estimation of pulmonary artery wedge pressure and pulmonary vascular resistance |
| title_full_unstemmed | A novel echocardiographic method for estimation of pulmonary artery wedge pressure and pulmonary vascular resistance |
| title_short | A novel echocardiographic method for estimation of pulmonary artery wedge pressure and pulmonary vascular resistance |
| title_sort | novel echocardiographic method for estimation of pulmonary artery wedge pressure and pulmonary vascular resistance |
| topic | Echocardiography Pulmonary artery wedge pressure Pulmonary vascular resistance Pulmonary hypertension Right heart catheterization |
| url | https://doi.org/10.1002/ehf2.13183 |
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