What role for echocardiography in primary pulmonary hypertension? New ultrasound methods accurately estimate pulmonary pressures.

Several echocardiographic techniques provide accurate, noninvasive estimates of peak or mean pulmonary artery pressure and can aid in diagnosing primary pulmonary hypertension. One such method involves converting peak tricuspid velocity to an estimated peak right ventricular minus right atrial gradient; peak pulmonary artery pressure is roughly equal to the sum of the tricuspid gradient estimate and estimated mean right atrial pressure. A second technique evaluates the contour of the transpulmonary Doppler velocity profile; a third measures the interval between pulmonary valve closure and tricuspid valve opening. An M-mode method can be used to assess wedge pressure. Echocardiographic variables can also help evaluate prognosis in primary pulmonary hypertension.