| [Objectives]To analyze the correlation of pulmonary arterial pressure in patients with simple shunt congenital heart disease,including simple atrial septal defect,ventricular septal defect and patent ductus arteriosus(PDA),by using echocardiogram(ECHO)and right ventricular catheter(RHC),so as to analyze the accuracy of echocardiography in estimating pulmonary artery pressure and explore the value of echocardiography in evaluating pulmonary artery hypertension.[Methods]Patients with congenital heart disease who were hospitalized in our hospital from January 1,2015 to December 31,2020 were selected as the research subjects.Base on that inclusion and exclusion criteria,1937 cases of simple atrial septal defect,188 case of simple ventricular septal defect and 294 cases of simple patent ductus arteriosus were included in the study.Collect the related data measured by echocardiography and right cardiac catheterization,according to the diagnosis of congenital heart disease,the research subjects were divided into three groups:patients with simple atrial septal defect,simple ventricular septal defect and simple patent ductus arteriosus.Statistical analysis was performed:1.PASP,the pulmonary artery systolic pressure measured by echocardiography,and sPAP,the pulmonary artery systolic pressure measured by right cardiac catheter in the three groups of subjects were analyzed with paired t-test,respectively,to determine whether there was a difference between the pulmonary artery systolic pressure estimated by echocardiography and the pulmonary artery systolic pressure measured by right cardiac catheter;2.Scatter plots of the pulmonary artery systolic pressure PASP measured by echocardiography and the pulmonary artery systolic pressure sPAP measured by right cardiac catheter were made respectively,and pearson correlation coefficient(correlation analysis)was obtained through linear analysis.3.Bland-Altman consistency analysis was performed on PASP measured by echocardiography and sPAP measured by right cardiac catheter in three groups of subjects respectively.[Results]1.Paired T-test of pulmonary artery systolic blood pressure measured by echocardiography and right cardiac catheter:All the patients in the three groups got P<0.05,which could be considered as statistically significant difference.It could be considered that there was difference in pulmonary artery systolic blood pressure measured by echocardiography and right cardiac catheter.2.Correlation analysis of pulmonary artery systolic blood pressure measured by echocardiography and right cardiac catheter:in patients with simple atrial septal defect,there is statistical difference between pulmonary artery systolic blood pressure measured by echocardiography and right cardiac catheter,and the correlation is medium(r=0.585,P<0.05),and the correlation is positive;In patients with simple ventricular septal defect,the pulmonary artery systolic blood pressure measured by echocardiography and right cardiac catheter had statistical difference and high correlation(r=0.866,P<0.05),showing a positive correlation;In patients with simple patent ductus arteriosus,the pulmonary artery systolic blood pressure measured by echocardiography and right cardiac catheter had statistical difference and high correlation(r=0.813,P<0.05),showing a positive correlation.3.Blank-Altman consistency analysis:in patients with simple atrial septal defect,the estimated deviation of echocardiography and right cardiac catheter to pulmonary artery systolic pressure is 7.6mmHg,and the 95%consistency range is-17.0-32.3 mmHg.The samples are not all in this range,and a large number of samples are outside the 95%consistency range.It can be considered that the estimation consistency of echocardiography and right cardiac catheter to pulmonary artery systolic pressure is poor.In patients with simple ventricular septal defect,the estimation deviation of pulmonary artery systolic pressure by echocardiography and right cardiac catheter was--3.5mmHg,and the 95%consistency range was-39.7-32.7 mmHg.Although most samples were within this range,the span of 95%consistency range was too large and not within the clinically acceptable range.It can be considered that the estimation consistency of pulmonary artery systolic pressure by echocardiography and right cardiac catheter was poor.In patients with simple patent ductus arteriosus,the estimated deviation of systolic pulmonary artery pressure between echocardiography and right cardiac catheter was--3.1mmHg,and the 95%consistency range was-37.7-31.5 mmHg.Although most samples were within this range,the span of this 95%consistency range was too large and not within the clinically acceptable range.It can be considered that the estimation consistency of systolic pulmonary artery pressure between echocardiography and right cardiac catheter was poor.[Conclusion]1.In this study,large sample analysis was used,and it was considered that the accuracy of pulmonary artery systolic blood pressure estimated by echocardiography was poor.Although it had a good correlation with the measured value of right cardiac catheter and showed a positive correlation,the measured values showed significant differences,which could only be used to understand the change trend of pulmonary artery systolic blood pressure.2.Echocardiography is not a substitute for gold standard right cardiac catheterization in measuring pulmonary arterial pressure.For patients who fail to undergo right cardiac catheterization,the assessment of pulmonary hypertension by echocardiography cannot be solely based on the estimation of pulmonary arterial pressure level.It should also comprehensively evaluate other echocardiographic signs of pulmonary hypertension as well as relevant parameters. |
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