Background
There is still controversy about whether transthoracic echocardiography (TTE) can
provide reliable estimations of pulmonary artery pressures (PAP). The primary endpoint
of this study was to evaluate the correlation between TTE and right heart catheterisation
(RHC) in estimating systolic (SPAP) and mean (MPAP) pulmonary artery pressures.
Methods
Between January 2011 and December 2018, 141 consecutive patients (average age 63.6±11.5
years; 84 women) with suspected or confirmed pulmonary hypertension (PH) were enrolled
into this retrospective observational monocentric study. All patients underwent TTE
and, within 3 hours, RHC. The correlation between TTE and RHC in estimating both SPAP
and MPAP was retrospectively determined.
Results
Seventeen (17) of the patients were excluded due to insufficient TTE signal quality.
Of the remaining 124 patients, 18 had no PH. There was moderate correlation between
both SPAP and MPAP estimated by TTE and those assessed by RHC (r=0.65 and r=0.60,
respectively). Bland-Altman analysis revealed a bias of –11.9 mmHg (with the 95% limits
of agreement ranging –45.4 to +21.5 mmHg) for SPAP estimation and –4.6 mmHg (with
the 95% limits of agreement ranging –27.9 to +18.8 mmHg) for MPAP estimation, suggesting
a general overestimation of PAP by TTE. The main factors responsible for discrepancies
between TTE and RHC were: female gender, arrhythmic cardiac electrical activity, systemic
arterial hypertension, and diuretic treatment.
Conclusions
Transthoracic echocardiography frequently overestimated PAP in comparison with RHC,
especially in hypertensive women with arrhythmias and under diuretic treatment.
Keywords
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Article info
Publication history
Published online: November 19, 2020
Accepted:
October 6,
2020
Received in revised form:
August 27,
2020
Received:
April 29,
2020
Identification
Copyright
© 2020 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
