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2019, Number 4

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Rev Hosp Jua Mex 2019; 86 (4)

The age of non-invasive measurements: echocardiographic equations methods to determine variables in the pulmonary vascular reactivity test

Muñoz-Hernández T, Hirschhaut-Schor E, Tovar-Blanco S, Lara-Boada G

Language: Spanish
References: 41
Page: 177-187
PDF size: 212.01 Kb.


ABSTRACT

Introduction and objectives: Right catheterization is the gold method to perform the pulmonary vascular reactivity test (PVRT), however, echocardiography has shown efficacy in the estimation of different hemodynamic variables. This study needs to demonstrate with the echocardiographic Doppler index, maximum speed of the tricuspid regurgitation (STR)/time-speed integral of the right ventricular outflow tract (TSIrvot), we obtain a pulmonary vascular resistance (PVR) value comparable to the invasive method. We evaluate its applicability in the PVRT. Methods: Prospective, double-blind, observational study in 30 patients, conducted in two stages: A) We obtained simultaneous measurements of PVR by invasive method and echocardiography (20). Measurements of the STR/TSIrvot index were correlated with invasive PVR using the analysis of linear regression. An equation was modeled to calculate PVR in Wood units (WU) by echocardiography, the results were compared with invasive PVR measurements using the Bland-Altman analysis. B) PVRT was performed by simultaneous measurement of PVR and pulmonary arterial medium pressure (PAMP) with the echocardiographic and invasive method (10). We use the equation formulated by Abbas and another modified proposal in this study. Results: In the first stage, the STR/TSIrvot ratio correlated well with the invasive PVR measurements (r = 0.95). The Bland-Altman analysis using PVR = 10x STR/TSIrvot + 0.36 showed satisfactory concordance limits (mean ± 0.36, L: 0.12-0.61). In the PVRT there was high correlation of PVR between the two methods using the two equations. We also found high correlation of PAMP. Conclusions: Doppler echocardiography offers a reliable and non-invasive method to measure PVR and PAMP in the PVRT.


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