Sensitivity and Specificity of Pulmonary Artery Pressure Measurement in Echocardiography and Correlation with Right Heart Catheterization.

Abstract

Objective: Echocardiography is helpful in assessment of pulmonary hemodynamic, however its correlation with Right heart catheterization (RHC) is conflicting. We conducted a study to evaluate sensitivity and specificity of pulmonary hemodynamic parameters measured in echocardiography. Furthermore its correlation with the values measured in RHC was assessed.

Method: Retrospective, cross-sectional study conducted at King Fahad medical City, Riyadh, Saudi Arabia. 95 adult patients referred for right heart catheterization were enrolled in the study. All the patients had echocardiography and RHC within one week of each other.

Result: Diabetes mellitus, hypertension and dyslipidemia were present among 55%, 66% and 41% of patients respectively. 85% of the study participants were diagnosed to have pulmonary hypertension and 79% of the study participants had postcapillary pulmonary hypertension. Sensitivity of pulmonary artery systolic pressure (PAPs), mean pulmonary artery pressure (PAPm) using PAPs and pulmonary artery acceleration velocity (PAcT) were 86%, 93% and 89% respectively. Correlation of PAPs, PAPm using PAPs and PAcT on echo with invasive hemodynamic in RHC were 0.56, 0.43 and 0.24 respectively. Among patients with moderate to severe Tricuspid Regurgitation (TR) and tricuspid annular plane systolic excursion (TAPSE) <1.5cm correlation of PAPs, PAPm using PAPs and PAcT on echocardiography with right heart catheterization were 0.31, 0.24 and 0.42 respectively.

Conclusion: Echocardiographic assessment of PAPs and PAPm has high sensitivity and weak to moderate correlation with hemodynamic data in RHC. PAPs measurement on echocardiogram has best correlation with invasive measurement followed by PAPm measurement using PAPs. Among patients with moderate to severe TR and TAPSE <1.5cm PAPm measurement using PAcT has better correlation than using PAPs.