Year : 2014  |  Volume : 7  |  Issue : 2  |  Page : 92--97

Non-invasive estimation of pulmonary vascular resistance in patients of pulmonary hypertension in congenital heart disease with unobstructed pulmonary flow


Arindam Pande1, Achyut Sarkar2, Imran Ahmed1, GS Naveen Chandra3, Shailesh Kumar Patil1, Chanchal Kumar Kundu1, Rahul Arora1, Ajanta Samanta4 
1 Department of Cardiology, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
2 Associate Professor of Cardiology and Incharge - Pediatric Cardiology Unit, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
3 Assistant Professor, Kasturba Medical College, Manipal, Karnataka, India
4 Clinical Tutor, Department of Gynaecology and Obstetrics, Radha Gobinda Kar Medical College and Hospital, Kolkata, West Bengal, India

Correspondence Address:
Dr. Arindam Pande
Flat-U 302, Binayak Enclave, 59 Kali Charan Ghosh Road, Kolkata-700 050, West Bengal
India

Context: Pulmonary vascular resistance (PVR) is a critical and essential parameter during the assessment and selection of modality of treatment in patients with congenital heart disease accompanied by pulmonary arterial hypertension. Aim: The present study was planned to evaluate non-invasive echocardiographic parameters to assess pulmonary vascular resistance. Settings and Design: This prospective observational study included 44 patients admitted in the cardiology and pediatric cardiology ward of our institution for diagnostic or pre-operative catheter based evaluation of pulmonary arterial pressure and PVR. Materials and Methods: Detailed echocardiographic evaluation was carried out including tricuspid regurgitation velocity (TRV) and velocity time integral of the right-ventricular outflow tract (VTI RVOT ). These parameters were correlated with catheter-based measurements of PVR. Results: The TRV/VTI RVOT ratio correlated well with PVR measured at catheterization (PVRcath) (r = 0.896, 95% confidence interval [CI] 0.816 to 0.9423, P < 0.001). Using the Bland-Altman analysis, PVR measurements derived from Doppler data showed satisfactory limits of agreement with catheterization estimated PVR. For a PVR of 6 Wood units (WU), a TRV/VTI RVOT value of 0.14 provided a sensitivity of 96.67% and a specificity of 92.86% (area under the curve 0.963, 95% confidence interval 0.858 to 0.997) and for PVR of 8 WU a TRV/VTI RVOT value of 0.17 provided a sensitivity of 79.17% and a specificity of 95% (area under the curve 0. 0.923, 95% confidence interval 0.801 to 0.982). Conclusions: Doppler-derived ratio of TRV/VTI RVOT is a simple, non-invasive index, which can be used to estimate PVR.


How to cite this article:
Pande A, Sarkar A, Ahmed I, Naveen Chandra G S, Patil SK, Kundu CK, Arora R, Samanta A. Non-invasive estimation of pulmonary vascular resistance in patients of pulmonary hypertension in congenital heart disease with unobstructed pulmonary flow.Ann Pediatr Card 2014;7:92-97


How to cite this URL:
Pande A, Sarkar A, Ahmed I, Naveen Chandra G S, Patil SK, Kundu CK, Arora R, Samanta A. Non-invasive estimation of pulmonary vascular resistance in patients of pulmonary hypertension in congenital heart disease with unobstructed pulmonary flow. Ann Pediatr Card [serial online] 2014 [cited 2020 Apr 2 ];7:92-97
Available from: http://www.annalspc.com/article.asp?issn=0974-2069;year=2014;volume=7;issue=2;spage=92;epage=97;aulast=Pande;type=0