Doppler echocardiographic evaluation of pulmonary artery pressure in chronic obstructive pulmonary disease. A European multicentre study

Abstract

The feasibility, reproducibility and reliability of Doppler echocardiography in evaluation of pulmonary artery pressure in patients with chronic obstructive pulmonary disease (COPD) were determined in a multicentre study. In 100 COPD patients with mean pulmonary artery pressure ranging from 10 to 62 mmHg at cardiac catheterization, pulmonary pressure estimation was attempted by four Doppler echocardiographic methods. These methods comprised the calculation of transtricuspid and transpulmonary pressure gradients from Doppler-detected tricuspid or pulmonary regurgitation, the evaluation of right ventricular outflow tract velocity profiles with the measurement of right ventricular systolic time intervals and the measurement of the right ventricular isovolumic relaxation time. In 98 (98%) patients at least one of the methods could be employed. A tricuspid regurgitation jet was detected in 47 (47%) patients but its quality was adequate for measurement in 30 (30%). Pulmonary regurgitation jet velocity was measured only in five cases. The standard error of estimate in testing intra- and interobserver reproducibility of Doppler systolic time intervals was less than 5%. The predictive value of right ventricular outflow tract acceleration time less than 90 ms in the identification of patients with mean pulmonary artery pressure greater than 20 mmHg was 80%. Of Doppler echocardiographic data, best correlations with mean pulmonary artery pressure were found for the transtricupid gradient (r = 0.73, SEE = 7.4 mmHg), for the right ventricular acceleration time (r = 0.65, SEE = 8 mmHg) and right ventricular isovolumic relaxation time (r = 0.61, SEE = 8.5 mmHg).(ABSTRACT TRUNCATED AT 250 WORDS)

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