The accuracy and influencing factors of Doppler echocardiography in estimating pulmonary artery systolic pressure: comparison with right heart catheterization: a retrospective cross-sectional study

• Published in: BMC medical imaging 2022-05, Vol.22 (1), p.91-91, Article 91
• Main Authors: Lv, Guang-Jie, Li, Ai-Li, Tao, Xin-Cao, Zhai, Ya-Nan, Zhang, Yu, Lei, Jie-Ping, Gao, Qian, Xie, Wan-Mu, Zhai, Zhen-Guo
• Format: Article
• Language: English
• Subjects: Accuracy; Analysis; Bias; Blood pressure; Cardiac catheterization; Catheterization; Correlation coefficient; Correlation coefficients; Cross-sectional studies; Diagnostic systems; Doppler effect; Echocardiography; Electrical equipment and supplies industry; Estimation; Heart; Hypertension; Intubation; Mathematical analysis; Medical research; Medical screening; Medicine, Experimental; Normal distribution; Pulmonary arteries; Pulmonary artery; Pulmonary hypertension; Regression analysis; Regurgitation; Reproducibility; Signal quality; Software; Statistical analysis; Systolic pressure; Veins & arteries; Ventricle
• ISSN: 1471-2342; 1471-2342
• DOI: 10.1186/s12880-022-00806-5

Noninvasive assessment of pulmonary artery systolic pressure by Doppler echocardiography (sPAP ) has been widely adopted to screen for pulmonary hypertension (PH), but there is still a high proportion of overestimation or underestimation of sPAP . We therefore aimed to explore the accuracy and influencing factors of sPAP with right heart catheterization (RHC) as a reference. A total of 218 highly suspected PH patients who underwent RHC and echocardiography within 7 days were included. The correlation and consistency between tricuspid regurgitation (TR)-related methods and RHC results were tested by Pearson and Bland-Altman methods. TR-related methods included peak velocity of TR (TR Vmax), TR pressure gradient (TR-PG), TR mean pressure gradient (TR-mPG), estimated mean pulmonary artery pressure (mPAP ), and sPAP . With mPAP ≥ 25 mm Hg measured by RHC as the standard diagnostic criterion of PH, the ROC curve was used to compare the diagnostic efficacy of sPAP with other TR-derived parameters. The ratio (sPAP -sPAP )/sPAP was calculated and divided into three groups as follows: patients with an estimation error between - 10% and + 10% were defined as the accurate group; patients with an estimated difference greater than + 10% were classified as the overestimated group; and patients with an estimation error greater than - 10% were classified as the underestimated group. The influencing factors of sPAP were analyzed by ordinal regression analysis. sPAP had the highest correlation coefficient (r = 0.781, P