AddPage
Doppler echocardiography
In the presence of tricuspid regurgitation and pulmonary insufficiency Doppler echocardiography allows a rough estimation of systolic and diastolic pulmonary artery pressures. Measurement of tricuspid regurgitant (TR) jet velocity by continuous wave Doppler echocardiography gives an estimation of RV systolic pressure (PAP). The end-diastolic velocity of pulmonary regurgitation reflects the end-diastolic pressure gradient between pulmonary artery and right ventricle. Adding right atrial pressure to the gradient allows assessment of systolic and diastolic pulmonary artery pressures. The early diastolic peak pulmonary regurgitant velocity and the RV outflow acceleration time allows estimation of mean PAP [1,2,3,4].
In the presence of tricuspid regurgitation and pulmonary insufficiency Doppler echocardiography allows a rough estimation of systolic and diastolic pulmonary artery pressures. Measurement of tricuspid regurgitant (TR) jet velocity by continuous wave Doppler echocardiography gives an estimation of RV systolic pressure (PAP). The end-diastolic velocity of pulmonary regurgitation reflects the end-diastolic pressure gradient between pulmonary artery and right ventricle. Adding right atrial pressure to the gradient allows assessment of systolic and diastolic pulmonary artery pressures. The early diastolic peak pulmonary regurgitant velocity and the RV outflow acceleration time allows estimation of mean PAP [1,2,3,4].
All Doppler echocardiographic measurements should be performed at breathhold or endexpiration and over three cardiac cycles. An insufficient tricuspid regurgitation signal ca be enhanced by administration of agitated saline.
Echocardiograph assessment of systolic PAP has several limitations: In patients with severe TR Doppler echocardiography tends to overestimate PAP [5]. The estimation of RAP is often a source of error [6,7]. As a consequence, estimation of systolic PAP based on Doppler echocardiography is not suitable for screening for mild, asymptomatic pulmonary hypertension [8].
In the echocardiography report we recommend to indicate the TR pressure gradient and systolic PAP. The assumed RAP should be indicated together with the method that was used for its estimation, e.g. height of jugular vein pressure. To document the hemodynamic implication cardiac output should be estimated.
Back to Medical > Diagnosis > Echocardiography
Back to Medical > Diagnosis > Echocardiography
Druckversion
Suche
SSPH Research Prize 2012
Deadline for submission: April 30, 2012
Further information
Symposium "pulmonal-arterielle Hypertension im Kindesalter"
Donnerstag, 10. Mai 2012, 16.00-18.00, Bern
Further information:
5th International Congress of the Swiss Society of Pulmonary Hypertension (SSPH)
28.-29. September 2012, Thun, Congress Hotel Seepark Thun
Informationen: www.imk.ch/sgph2012
mehr