演題

PJ057-3

The Accuracy of Diagnosis of Pulmonary Hypertension Using Doppler Derived Peak Tricuspid Regurgitation Pressure Gradient with Echocardiography

[演者] 澤田 直子:1
[共同演者] 川田 貴之:1, 大門 雅夫:2, 木村 公一:1, 中尾 倫子:2, 廣川 愛美:1, 石渡 惇平:1, 桐山 皓行:1, 徐 博卿:2, 渡辺 昌文:1, 小室 一成:1
1:東京大学 循環器内科, 2:東京大学 検査部

Background: Noninvasive and accurate diagnosis of pulmonary hypertension (PH) has been gaining attention. The definition of PH is defined as an increase in mean pulmonary artery pressure (PAP) ≥ 25mmHg at rest as assessed by right heart catheterization. On the other hand, there may be a discrepancy between Doppler derived systolic PAP by non-invasive echocardiography and mean PAP by invasive catheterization. We explored the best cut-off value of tricuspid regurgitation pressure gradient (TRPG) for detecting PH (PAP ≥ 25mmHg) assessed by catheterization.Methods and Results: We studied 189 patients who underwent right heart catheterization. Echocardiography was performed within 24 hours of invasive evaluation. In total, 26% of patients had PH. Median mean PAP and median TRPG were 16 mmHg and 27 mmHg, respectively and there was a significant correlation between them (r= 0.83, p <0.0001). From the receiver-operating characteristics curve, the optimal TRPG cut-off for detecting PH was 36mmHg (sensitivity, 90%; specificity, 93%; area under the curve = 0.95).Conclusion: The optimal TRPG cut-off for detecting PH was 36mmHg with high sensitivity and specificity. Although there is a small discrepancy in the assessment of PH between echocardiography and catheterization, Doppler derived TRPG predicts PH with acceptable accuracy. Further investigation is needed to develop more accurate techniques to predict PH noninvasively.

[Keywords] echocardiography / pulmonary hypertension
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