Journal of the American Society of Echocardiography
Volume 22, Issue 7 , Pages 814-819, July 2009

An Alternative Echocardiographic Method to Estimate Mean Pulmonary Artery Pressure: Diagnostic and Clinical Implications

  • Javier F. Aduen, MD

      Affiliations

    • Division of Pulmonary Medicine, Mayo Clinic, Jacksonville, Florida
  • ,
  • Ramon Castello, MD

      Affiliations

    • Division of Cardiovascular Diseases, Mayo Clinic, Jacksonville, Florida
    • Corresponding Author InformationReprint requests: Ramon Castello, MD, Apex Cardiovascular Group, Florida Physicians Research Associates, 6428 Beach Boulevard, Jacksonville, FL 32216.
  • ,
  • Marcelo M. Lozano, MD

      Affiliations

    • Division of Cardiovascular Diseases, Mayo Clinic, Jacksonville, Florida
  • ,
  • George N. Hepler, RDCS

      Affiliations

    • Division of Cardiovascular Diseases, Mayo Clinic, Jacksonville, Florida
  • ,
  • Cesar A. Keller, MD

      Affiliations

    • Division of Pulmonary Medicine, Mayo Clinic, Jacksonville, Florida
  • ,
  • Francisco Alvarez, MD

      Affiliations

    • Division of Pulmonary Medicine, Mayo Clinic, Jacksonville, Florida
  • ,
  • Robert E. Safford, MD

      Affiliations

    • Division of Cardiovascular Diseases, Mayo Clinic, Jacksonville, Florida
  • ,
  • Julia E. Crook, PhD

      Affiliations

    • Biostatistics Unit, Mayo Clinic, Jacksonville, Florida
  • ,
  • Michael G. Heckman, MS

      Affiliations

    • Biostatistics Unit, Mayo Clinic, Jacksonville, Florida
  • ,
  • Charles D. Burger, MD

      Affiliations

    • Division of Pulmonary Medicine, Mayo Clinic, Jacksonville, Florida

published online 08 June 2009.

Jacksonville, Florida

Background

The aim of this study was to evaluated an alternative echocardiographic method to calculate mean pulmonary arterial pressure (MPAP).

Methods

One hundred two patients were studied with simultaneous right-heart catheterization (RHC) and echocardiography. MPAP was calculated by adding the right ventricular–right atrial mean systolic gradient to right atrial pressure.

Results

The mean difference between MPAP calculated using this method and RHC-derived MPAP was −1.6 mm Hg, less than that of traditional systolic pulmonary arterial pressure (SPAP; −6.4 mm Hg) and MPAP estimated using the pulmonary regurgitation method (−13.9 mm Hg). The median absolute percentage difference of the MPAP calculations relative to RHC was significantly less with this method than with the pulmonary regurgitation method (18% vs 71%; P < .001) and similar to the SPAP method (both 18%; P = .30).

Conclusion

MPAP calculated using the proposed method is as accurate as SPAP calculation and less variable than previous methods, thus allowing widespread clinical use.

Keywords: Doppler echocardiography, Mean pulmonary pressure, Pulmonary hypertension

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 This paper was presented in part at the American Thoracic Society International Conference, San Francisco, CA, May 18-23, 2007.

PII: S0894-7317(09)00367-8

doi:10.1016/j.echo.2009.04.007

Journal of the American Society of Echocardiography
Volume 22, Issue 7 , Pages 814-819, July 2009