Echocardiographic Assessment of Pulmonary Hypertension in Patients with Heart Diseases Compared with Cardiac Catheterization

Background: Pulmonary hypertension (PH) is a haemodinamic and pathophysiological condition defined as increase in mean Pulmonary Artery Pressure (PAP) > 25mmHg at rest as sessed by right heart catheterization (RHC). Objective and purpose: The objective of this study is to determine, by investigating haemodynamic parameters of the pulmonary hypertension in congenital and left heart diseases, the linkage and diagnostic value of echocardiography in detecting the pulmonary hypertension in heart diseases and assessing its degree, as well as to warrant a wider application of this non-invasive diagnostic method. Patients and methods: The research covered 56 adult subjects of both genders, who were subjected to echocardiography as part of the clinical cardiological examination. The patients were examined on an ultrasound machine ATL HDI-3000 and 5000, equipped with a cardiologic probe for adults 2.25 MHz and a multi-plan transoesophageal probe ATL MPT7-4 TEE. The patients, for whom invasive cardiologic diagnostic methods were indicated following evaluation by echocardiography, were subjected to cardiac catheterization. RHC was performed in all patients and diagnosis of pulmonary hypertension was established by measuring mean PAP > 25mmHg at rest, also left heart catheterization was performed in order to define the underlying heart disease. The haemodynamic parameters, obtained for each method applied, have been statistically processed. Results: By the statistical processing of the echocardiographic parameters a correlation ratio has been found, which shows significant correlation between the non-invasive variables (AcT, Act/RVET, PEP/AcT, PEP/RVET and RVSP according to modified Bernoulli equation. MPAP according to Mahanʹs equation, SPAP according to Bergerʹs equation) and the variables obtained by right heart catheterization (RHC): (RVSP, MPAP, SPAP): a) In AcT and AcT/RVET variables, a negative correlation was found AcT r = -0.936, Standard Estimation Error (SEE) = 5.53, p <0.001. AcT/RVET r = -0.896, SEE = 6.96, p <0.001; b) while positive correlation was found in variables PEP/AcT r = 0.915, SEE = 6.36, p <0.001 and PEP/RVET r = 0.917, SEE = 6.26, p <0.001; c) MPAP obtained by echocardiography (calculated by applying Mahanʹs equation) V.S. MPAP obtained by right heart catheterization r = 0.936, SEE = 5.53 mmHg; d) SPAP obtained by echocardiography (calculated by applying Bergerʹs equation) V.S. SPAP obtained by right heart catheterization r = 0.971, SEE = 5.72 mmHg; e) RVSP obtained by echocardiography (calculated by applying a modified Bernoulliʹs equation) V.S. RVSP obtained by right heart catheterization r = 0.882, SEE = 9.399 mmHg; f) RVSP obtained by echocardiography (calculated by applying a modified Bernoulliʹs equation) V.S. SPAP obtained by RHC r = 0.972, SEE = 5.60 mmHg. Conclusion: Significant correlation has been found between the haemodynamic parameters obtained by noninvasive echocardiographic examination and those obtained by right heart catheterization.