A Comparative Study Of Doppler Echocardiography Estimation And Right Heart Catheterization Measurement Of Pulmonary Artery Pressure In Patients With ASD

Objective:In this study,To find the correlation,difference,and range of difference betweenthe two methods of detecting pulmonary arterial pressure using Doppler echocardiography(D-ECHO)and R ight heart catheterization(RHC),D-ECHO estimation contrasts with R-HC for measurement of pul monary artery pressure are performed in patients with atrial septal defect;At the same time,looki ng for the possible causes of errors in estimating pulmonary artery systolic pressure by D-ECHO a nd the methods to improve and correct the errors.Methods:1)Perform general data analysis through multiple linear regression analysis;2)U-se Pears on or Spearman correlation analysis to find the correlation between RHC measurement of pulmona ry artery pressure,right ventricular pressure and D-ECHO estimated pulmonary artery systolic press ure(s PAP);3)Use Bland-Altman analysis to find the consistencyand difference range of two detect ion methods to measure pulmonary artery pressure;4)Perform a comparative analysis between the pulmonary artery pressure,right ventricular pressure measured by RHC and s PAP estimated by D-ECHO by paired T test or Wilcoxon rank sum test to find the differences between the two method s;5)The pulmonary artery systolic pressure(s PAP)is estimated by D-ECHO,the pulmonary artery systolic pressure(s PAP)and the pulmonary artery mean pressure(m PAP)are measured by RHC ar e Performed Pearson or Spearman correlation analysis with the parameters used in the D-ECHO es timation method to find possible causes of errors in the D-ECHO estimation method;6)The ROC curve is used to further determine the best cut-off value,sensitivity and specificity of the peak tricu spid regurgitation velocity(TVRVmax)for predicting PH;all data are used SPSS25.0 software for statistical processing.Results:1.the influence of age on D-ECHO’s estimation of s PAP is statistically significant(r~2=0.061,P<0.05).2.RHC measurement of pulmonary artery systolic pressure(s PAP),pulmonary artery meanpressure(m PAP),right ventricular systolic pressure(s RVP)and D-ECHO estimated s PAP are all positively c orrelated,and all have significant statistical significance(P values are P<0.01);There is no correlati on between right ventricular mean pressure(m RVP)measured by RHC and s PAP estimated by D-ECHO(P>0.05).3.The average value of the difference between s PAP estimated by D-ECHO and s PAP measured b y RHC is 4.17mm Hg,of which 62.83%are accurate,9.74%are underestimated,and 27.43%are o verestimated;The mean value of the difference between s PAP estimated by D-ECHO and m PAP measured by RHC was 20.38mm Hg,of which 16.81%are measured accurately and 83.19%are o-ver estimated.4.The results of comparative analysis between RHC measured s PAP,m PAP,s RVP,m RVPand D-E CHO estimated SPAP are statistically significant(P<0.01,P<0.01,P<0.05,P<0.01).5.D-ECHO estimation of s PAP and right atrial diameter(RAID),right ventricular diameter(RVID),main pulmonary artery diameter(MPAD),TVRVmax(peak tricuspid regurgitation velocity),RAP(r ight atrial pressure))Are positively correlated(P values are P<0.01);RHC measured s PAP and D-ECHO measured RVID,MPAD,TVRVmax are positively correlated(P<0.05,P<0.01,P<0.01),R HC measurement of s PAP has no correlation with RAID,RAP;RHC measurement of m PAP has a positive correlation with D-ECHO measurement of MPAD,TVRVmax(P values are P<0.01),R HC measurement of m PAP has no correlation with RAID,RVID,RAP.6.The best cut-off value of TVRVmax for predicting PH is 2.78m/s,the sensitivity is 83%,and th e specificity is 57%(AUC is 0.74,P<0.01).Conclusion:1.The two methods of D-ECHO and RHC to measure pulmonary artery pressure have both correla tion and difference.D-ECHO estimates s PAP with overestimation and underestimation,and the over estimation is significantly greater than the underestimation.D-ECHO estimates the pulmonary artery pressure inaccurately.2.RAID and RAP are both important reasons for the overestimation and errors in the D-ECHO esti mation of s PAP.TVRVmax and RVID may be one of the reasons for the overestimation of D-EC HO’s estimation of s PAP.3.The method of improving D-ECHO’s assessment of pulmonary artery pressure has little effect on improving the accuracy of D-ECHO’s assessment of PH and correcting errors.On the basis of D-E CHO screening,routine RHC inspections are still needed to provide Accurate diagnosis basis for cl inical and scientific research.