PMID- 10232436
OWN - NLM
STAT- MEDLINE
DCOM- 19990629
LR  - 20190822
IS  - 0903-1936 (Print)
IS  - 0903-1936 (Linking)
VI  - 13
IP  - 3
DP  - 1999 Mar
TI  - Proximal pulmonary emboli modify right ventricular ejection pattern.
PG  - 616-21
AB  - Analysis of the systolic flow velocity curve (SFVC) in the right ventricular 
      outflow tract is considered as an alternative to the tricuspid valve pressure 
      gradient (TVPG) method for echo-Doppler assessment of pulmonary arterial pressure 
      (P(pa)). The present study checked whether or not SFVC is affected by the cause 
      of pulmonary hypertension. Doppler recordings of 86 patients (39 female, aged 
      55.5+/-15.2 yrs) with acute (AP-PE) or chronic (CP-PE) proximal pulmonary 
      embolism, chronic obstructive pulmonary disase (COPD) or primary pulmonary 
      hypertension (PPH) were retrospectively analysed by two observers unaware of the 
      purpose of the study. Despite having the lowest TVPG (48+/-13 mmHg), patients 
      with AP-PE had the shortest acceleration time (t(acc); 56+/-15 ms) and time to 
      midsystolic deceleration (t(msd); 105+/-16 ms). t(acc) <60 ms in patients with 
      TVPG <60 mmHg had 98% specificity and 48% sensitivity for AP-PE. In PPH, SFVC was 
      less abnormal (t(acc) 64+/-14 ms, t(msd) 125+/-25 ms, both p<0.03) despite having 
      a TVPG twice as high (92+/-12 mmHg, p< 0.001). In contrast to t(acc), TVPG showed 
      strong correlation with direct P(pa) measurements whenever performed (r=-0.43, 
      p=0.02, versus r=0.80, p<0.001; n=30). There was no correlation between t(acc) 
      and TVPG in a pooled study group and SFVC seemed strongly affected by the 
      presence of both AP-PE and CP-PE. While potentially useful for evaluation of the 
      true right ventricular afterload during pulsatile flow conditions, the systolic 
      flow velocity curve does not provide a reliable estimate of pulmonary arterial 
      pressure.
FAU - Torbicki, A
AU  - Torbicki A
AD  - Dept of Internal Medicine, National Tuberculosis and Lung Disease Research 
      Institute, Warsaw, Poland.
FAU - Kurzyna, M
AU  - Kurzyna M
FAU - Ciurzynski, M
AU  - Ciurzynski M
FAU - Pruszczyk, P
AU  - Pruszczyk P
FAU - Pacho, R
AU  - Pacho R
FAU - Kuch-Wocial, A
AU  - Kuch-Wocial A
FAU - Szulc, M
AU  - Szulc M
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - England
TA  - Eur Respir J
JT  - The European respiratory journal
JID - 8803460
SB  - IM
MH  - Adult
MH  - Aged
MH  - Diagnosis, Differential
MH  - Echocardiography, Doppler
MH  - Female
MH  - Humans
MH  - Hypertension, Pulmonary/diagnosis/etiology/*physiopathology
MH  - Male
MH  - Middle Aged
MH  - Pulmonary Circulation/physiology
MH  - Pulmonary Embolism/*diagnostic imaging/pathology/*physiopathology
MH  - Reproducibility of Results
MH  - Retrospective Studies
MH  - Sensitivity and Specificity
MH  - *Stroke Volume
EDAT- 1999/05/08 00:00
MHDA- 1999/05/08 00:01
CRDT- 1999/05/08 00:00
PHST- 1999/05/08 00:00 [pubmed]
PHST- 1999/05/08 00:01 [medline]
PHST- 1999/05/08 00:00 [entrez]
AID - 10.1183/09031936.99.13361699 [doi]
PST - ppublish
SO  - Eur Respir J. 1999 Mar;13(3):616-21. doi: 10.1183/09031936.99.13361699.