Evaluate The Accuracy Of B-TDE Estimate PASP With The Patients After Heart Valve Replacement Surgery In ICU

Objective To evaluate the accuracy of bedside transthoracic dopplerechocardiography（B-TDE）vs right-heart catheterization in detectingpulmonary artery systolic pressure（PASP） in ICU patients who havealready received heart valve replacement surgery.Methods We enrolled72patients with valvular diseases who wereavailable for a heart valve replacement surgery. A right cardiac catheter wasplaced before surgery. Forty-eight hours after the surgery, PASP wasmeasured directly through right cardiac catheterization or indirectly, bycalculation according to tricuspid maximum reverse flow velocity measuredby B-TDE.Results Seventy-two patients were devided into three groups:12withaortic valve replacement (Group A),38with mitral valve replacement(Group B) and22with double valve replacement (Group C). The PASPvalues measured by two methods in three groups were: GroupA B-TDE(35±12)mmHg VS right-heart catheterization (36±16)mmHg，P=0.765; GroupBB-TDE (38±13)mmHg VS right-heart catheterization (36±14)mmHg，P=0.705;GroupC B-TDE (38±14)mmHg VS right-heart catheterization (40±12)mmHg，P=0.685. There were no statistical significance in all three groups. The PASPestimated from B-TDE was positively correlated with the PASP measuredby right cardiac catheterization[(38±5)mmHg VS (46±5)mmHg，P>0.05，r=0.68]. The PASP measured by B-TDE and right heart catheterization in patientswith right atrium diameter>50mm were (38±11)mmHg vs (38±12)mmHg, P=0.852,while in patients with right atrium diameter <50mm were (37±14)mmHg vs(37±14)mmHg，P=0.474.PASP measured by B-TDE or right heart catheterization didnot make any statistical significances in both patient groups.PASP measurementsobtained by B-TDE were correlated with those obtained through right cardiaccatheterization: the correlation coefficients in Group A, B and C were0.64,0.68and0.61, respectively (P<0.05in all three circumstances). In31cases, the gratitude betweenB-TDE-estimated PASP and right cardiac catheterization-measured PASP exceeded10mmHg. In22(30.5％) out of these31cases, B-TDE-estimated PASP exceeds rightcardiac catheterization-measured PASP and9(12.5％) vice versa.Conclusion B-TDE may provide reliable estimated PASP valuescomparing with those generated by right cardiac catheterization. The exactclinical significance of BTDE in heart valve replacement surgery isworthy of further investigations.