Relationship between pulmonary artery systolic pressure estimated by Doppler echocardiography and values obtained by right heart catheterization.

Abstract

Introduction: Right heart catheterization is the gold standard for the diagnosis of pulmonary hypertension. Doppler echocardiography is a less invasive tool that could assist in the initial treatment and detection of patients with this disease.

Methodology: A retrospective study was conducted of patients undergoing right heart catheterization at our institution who had simultaneous cardiac Doppler studies within 48 hours of the catheterization.

Results: A total of 206 patients underwent right heart catheterization, of whom 98 were women (47%), with a mean age of 50 years. The mean mPASP estimated by RHC was 55 mmHg, vs. 47 mmHg by transthoracic echocardiogram. Type 1 PAH was the predominant group, accounting for 47% of the cases, mainly attributable to congenital heart disease with shunting. The most common comorbidity in the study population was heart failure (52%). The mPASP correlation coefficient was 0.83 (p < 0.03), indicating a strong correlation across the entire sample. However, the concordance was 0.35 (CI: 0.13 - 0.21), and the intraclass correlation coefficient was 0.09, indicating low concordance between the two methods.

Conclusion: The agreement between right catheterization and transthoracic echocardiography for measuring mPSAP in patients with Pulmonary Hypertension is poor for establishing a diagnosis and for patient follow-up.