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A new method to estimate pulmonary vascular resistance using diastolic pulmonary artery-right ventricular pressure gradients derived from continuous-wave Doppler velocity measurements of pulmonary regurgitation

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Abstract

Pulmonary vascular resistance (PVR) is an important hemodynamic parameter in patients with heart failure, especially when the pulmonary arterial pressure is lower due to reduced stroke volume. Several echocardiographic methods to estimate PVR have been proposed, but their applications in patients with organic left-sided heart diseases have been limited. The aim of the present study was to examine the usefulness of our new method to estimate PVR (PVRPR) based on the continuous-wave Doppler velocity measurements of pulmonary regurgitation in these patients. In 43 patients who underwent right heart catheterization, PVRPR was calculated as the difference between the Doppler-derived early- and end-diastolic pulmonary artery (PA)-right ventricular (RV) pressure gradients divided by the cardiac output measured in the left ventricular outflow tract by echocardiography. The PVRPR correlated well with invasive PVR (PVRCATH) (r = 0.81, p < 0.001) without any fixed bias in Bland–Altman analysis. The conventional echocardiographic PVRs showed inadequate correlations with PVRCATH, or a obvious overestimation of PVRCATH. In the receiver operating characteristic analyses to determine the patients with abnormal elevation of PVRCATH (>3 Wood units, WU), the area under the curve was the greatest for PVRPR (0.964) compared to the conventional PVRs (0.649–0.839). PVRPR had 83 % sensitivity and 100 % specificity at the optimal cut-off value of 3.10 WU in identifying patients with PVRCATH >3 WU. Our simple and theoretical PVRPR is useful for the noninvasive estimation of PVR.

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Authors and Affiliations

  1. Faculty of Health Sciences, Hokkaido University, Kita-12, Nishi-5, Kita-ku, Sapporo, 060-0812, Japan

    Sanae Kaga, Taisei Mikami, Kazunori Okada & Nobuo Masauzi

  2. Graduate School of Health Sciences, Hokkaido University, Kita-12, Nishi-5, Kita-ku, Sapporo, 060-0812, Japan

    Michito Murayama

  3. Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, Sapporo, 060-8648, Japan

    Masahiro Nakabachi, Hisao Nishino, Shinobu Yokoyama & Mutsumi Nishida

  4. Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638, Japan

    Sanae Kaga, Taichi Hayashi, Daisuke Murai, Hiroyuki Iwano, Mamoru Sakakibara, Satoshi Yamada & Hiroyuki Tsutsui

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  1. Sanae Kaga
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  2. Taisei Mikami
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Correspondence to Taisei Mikami.

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Kaga, S., Mikami, T., Murayama, M. et al. A new method to estimate pulmonary vascular resistance using diastolic pulmonary artery-right ventricular pressure gradients derived from continuous-wave Doppler velocity measurements of pulmonary regurgitation. Int J Cardiovasc Imaging 33, 31–38 (2017). https://doi.org/10.1007/s10554-016-0965-2

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  • DOI: https://doi.org/10.1007/s10554-016-0965-2

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