The Value Of Color Doppler Ultrasound In Detecting Pulmonary Vascular Resistance

Objective:To evaluate the accuracy of color Doppler ultrasound in detecting pulmonary vascular resistance(PVR) by comparing with that of Right-heart catheterization(RHC).Methods:29inpatients(admission time:02/2013-12/2013) with high pulmonary artery systolic pressure(PASP>35mmHg) were recruited and their Doppler echocardiography and right-heart catheterization were performed in same day. The PVR were calculated each using the following date from Doppler echocardiography:TRV/V-Arvot ratio, TRV/VTIrvot ratio, PIV/VTIpa ratio and TRV/VTIlvot ratio. Meanwhile, the PASP. PADP、PAMP、PCWP、 QP of each patient were recorded using right-heart catheterization, and PVR was calculated by the following formulae:PVR=(PAMP-PCWP)/QP. The results of the mentioned four methods above in the UCG group were compared with the invasive PVR of the RHC group using the correlation and regression analysis. Furthermore, a plot of PVRucg compared with PVRrhc was generated using the Bland-Altman analysis.Results:As calculated by Doppler echocardiography, the PVR of all the four methods correlated well with the invasive PVR (r=0.71、0.76.0.69、0.74, P<0.05), and the method using TRV/VTIrvot ratio performs better. Bland-Altman analysis showed a homogeneous distribution with a difference of±1.13WU for the equation using TRV/V· Arvot,±1.01WU for that using TRV/VTIrvot,±1.10WU for that using PIV/VTIpa,±1.21for that using TRV/VTIlvot.Conclusion:1.Doppler echocardiography and right heart catheterization are highly correlated in determining PVR, the correlation is from0.69to0.76. Doppler echocardiography is a valuable non-invasive method to diagnose PH patients.2. The PVR obtained by UCG need fewer variables and can be easily required in our study. This UCG method is worthy for clinical promotion and application. The method using TRV/VTIrvot ratio has a highest correlation comparing with that of Fick method. 3. When someone do the UCG, if the patient is in a PASP>35mmHg, routine PVR measurement is recommend. When the tricuspid regurgitation can get, methods using TRV/VTIrvot ratio may be better choices; If tricuspid regurgitation can not get, and pulmonary regurgitation can get, methods using PIV/VTIpa ratio may be better choices.