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Clinical InvestigationsNoninvasive Estimation of Systolic Pulmonary Artery Pressure Using Doppler Echocardiography in Patients with Chronic Obstructive Pulmonary Disease
Section snippets
Patients and Methods
The group included 41 consecutive patients with COPD (32 male and nine female patients) who were referred for right heart catheterization. These patients had either chronic bronchitis, characterized by cough and sputum during at least three months of the year for at least two consecutive years, or emphysema characterized by dyspnea with radiologic evidence of emphysema and functional evidence of airway obstruction (FEV1/FVC <55 percent). The patients were in stable condition during the three
Results
The hemodynamic data are summarized in Table 2. The mean value of systolic PAP for the entire group was 38.5±14.9 mm Hg. Fifty-one percent (21/41) of patients had pulmonary arterial hypertension.
An analyzable Doppler tricuspid diastolic signal was obtained in 93 percent (38/41) of patients. The echo-Doppler did not detect TR in eight patients: seven of these eight patients had normal PAP. In 73 percent (30/41) of patients, the echo-Doppler detected a TR, but in three of them, the Doppler signal
Discussion
This prospective study demonstrated in a group of 41 patients with COPD that CWD could be used to estimate PAPs in 66 percent of patients. There was a statistically significant correlation (r=0.65, p<0.001) between the Doppler-estimated PAP and the catheter-measured PAPs. Continuous-wave Doppler ultrasound detected the presence of PAH with a high sensitivity (94 percent). When CWD did not detect a TR or when the Doppler-estimated PAP was below 35 mm Hg, the presence of PAH was highly unlikely.
References (25)
- et al.
Pulmonary hypertension in chronic obstructive pulmonary disease: multivariate analysis
Chest
(1986) - et al.
Physiologic correlates of right ventricular ejection fraction in chronic obstructive pulmonary disease: a combined radionuclide and hemodynamic study
Am J Cardiol
(1982) - et al.
Detection of right ventricular pressure overloading by thallium-201 myocardial scintigraphy: results in 57 patients with chronic respiratory diseases
Chest
(1984) - et al.
Quantitative assessment of pulmonary hypertension in patients with tricuspid regurgitation using continuous wave Doppler ultrasound
J Am Coll Cardiol
(1985) - et al.
Continuous wave Doppler determination of right ventricular pressure: a simultaneous Doppler-catheterization study in 127 patients
J Am Coll Cardiol
(1985) - et al.
Two-dimensional echocardiographic assessment of the right ventricle in patients with chronic obstructive lung disease
Chest
(1987) - et al.
Right ventricular ejection fraction in severe chronic airway obstruction
Chest
(1977) - et al.
Magnitude and implications of spontaneous hemodynamic variability in primary pulmonary hypertension
Am J Cardiol
(1985) - et al.
Comparison of three Doppler ultrasound methods in the prediction of pulmonary artery pressure
J Am Coll Cardiol
(1987) - et al.
Improved recognition of cor pulmonale in patients with severe chronic obstructive pulmonary disease
Am J Med
(1988)
Noninvasive prediction of pulmonary hypertension in chronic obstructive pulmonary disease by Doppler echocardiography
Chest
Physiological variables and mortality in patients with various categories of chronic respiratory disease: WHO multicenter study
Bull Eur Physiopathol Respir
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Prevalence of pulmonary hypertension in COPD patients living at high altitude
2022, PulmonologyCitation Excerpt :Some studies have found that sPAP estimated by TTE has a significantly high level of agreement with catheterization measurements.67,69 We used an estimated sPAP > 36 mmHg to define pH, a cut-off point that has been described as having high sensitivity, specificity, and good negative predictive value for the diagnosis of PH.31,32,67 We used indirect signs and contrast with shaken saline for improving the operating characteristics of the TTE, as has been described.27,28,63 In conclusion, the prevalence of PH in patients with COPD living in Bogotá, a city located at HA (2640 m), is high and greater than that described at sea level, particularly in patients with less severe airflow limitation, suggesting a higher risk of developing PH for COPD patients living in HA compared to COPD patients with similar airflow limitation living at low altitudes.
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Manuscript received February 22; revision accepted June 1.