Doutreleau Stéphane, Canuet Matthieu, Enache Irina, Di Marco Paola, Lonsdorfer Evelyne, Oswald-Mammoser Monique, Charloux Anne
Department of Physiology, INSERM U1042, HP2.
Circ J. 2016 Aug 25;80(9):2019-25. doi: 10.1253/circj.CJ-16-0206. Epub 2016 Aug 4.
Echocardiography (ECHO) plays a key role in both the diagnosis and prognosis of pulmonary hypertension (PH). Many equations have been published to assess right heart hemodynamics using ECHO. The objective of this study was to test the accuracy and precision of different echocardiographic equations in comparison with the right heart catheterization.
Complete right heart hemodynamic assessments were prospectively obtained from 115 individuals (mean age 66±1 years; 57 males) who had known or suspected PH. Several equations were tested for the estimation of right atrial pressure, mean and systolic pulmonary artery pressure (MPAP), cardiac output, pulmonary capillary wedge pressure (PCWP), and pulmonary vascular resistance (PVR). The accuracy of ECHO was good, with a mean difference <2 mmHg for all of the pressure calculations and ±0.6 L/min for cardiac output. However, the PVR estimation was weak using any one of the formulae. For all the parameters, the precision of ECHO was moderate. The MPAP calculation detected PH with a sensibility of 97% and specificity of 83%. However, ECHO underdiagnosed post-capillary PH.
ECHO is a good method for the diagnosis of PH, with an adequate calculation of right pressures, but cannot accurately calculate PCWP and PVR. (Circ J 2016; 80: 2019-2025).
超声心动图（ECHO）在肺动脉高压（PH）的诊断和预后评估中起着关键作用。已经发表了许多使用ECHO评估右心血流动力学的公式。本研究的目的是与右心导管检查相比，测试不同超声心动图公式的准确性和精确性。
前瞻性地从115名已知或疑似患有PH的个体（平均年龄66±1岁；57名男性）中获得完整的右心血流动力学评估。测试了几个公式用于估计右心房压力、平均和收缩期肺动脉压力（MPAP）、心输出量、肺毛细血管楔压（PCWP）和肺血管阻力（PVR）。ECHO的准确性良好，所有压力计算的平均差异<2 mmHg，心输出量的平均差异为±0.6 L/min。然而，使用任何一个公式估计PVR的效果都较差。对于所有参数，ECHO的精确性中等。MPAP计算检测PH的敏感性为97%，特异性为83%。然而，ECHO对毛细血管后PH的诊断不足。
ECHO是诊断PH的一种好方法，对右心压力的计算足够，但不能准确计算PCWP和PVR。（《循环杂志》2016年；80：2019 - 2025）
