%0 Journal Article
%T Reappraisal of the reliability of Doppler echocardiographic estimations for mean pulmonary artery pressure in patients with pulmonary hypertension: a study from a tertiary centre comparing four formulae
%A Aykun Hakgor
%A Berhan Keskin
%A Cem Dogan
%A Cihangir Kaymaz
%A Hacer Ceren Tokgoz
%A Ibrahim Halil Tanboga
%A Nertila Poci
%A Nihal Ozdemir
%A Ozgur Yasar Akbal
%A Rezzan Deniz Acar
%A Seda Tanyeri
%A Sevim Turkday
%A Tugba Aktemur
%A Zubeyde Bayram
%J Pulmonary Circulation
%@ 2045-8940
%D 2018
%R 10.1177/2045894018762270
%X Different Doppler echocardiography (DE) models have been proposed for estimation of mean pulmonary arterial pressures (PAMP) from tricuspid regurgitation (TR) jet velocity. We aimed to compare four TR-derived DE models in predicting the PAMP measured by right heart catheterization (RHC) in different groups of precapillary pulmonary hypertension (PH). A total of 287 patients with hemodynamically pre-capillary PH were enrolled (mean age£¿=£¿51£¿¡À£¿17.4 years, 59.9% female). All patients underwent DE before RHC (< 3£¿h) and four formulae (F) were used for TR-derived PAMP estimation (PAMP-DE). These were as follows: F1£¿=£¿Chemla (0.61£¿¡Á£¿systolic pulmonary artery pressure [PASP]£¿+£¿2); F2£¿=£¿Friedberg (0.69£¿¡Á£¿PASP£¿£¿£¿0.22), F3£¿=£¿Aduen (0.70£¿¡Á£¿PASP); and F4£¿=£¿Bech-Hanssen (0.65£¿¡Á£¿PASP£¿£¿£¿1.2). The PASP and PAMP (mmHg) measured by RHC were 89.1£¿¡À£¿30.4 and 55.8£¿¡À£¿20.8, respectively. In the overall PH group, DE estimates for PASP (r£¿=£¿0.59, P£¿=£¿0.001) and PAMP (r£¿=£¿0.56, P£¿=£¿0.001 for all) showed significant correlations with corresponding RHC measures. Concordance was noted between Chemla and Bech-Hanssen, and Aduen and Bech-Hanssen. The Bland¨CAltman plot showed that Chemla and Bech-Hanssen overestimated and Friedberg and Aduen underestimated PAMP-RHC measures. Paired-t test showed significant systematic biases for Aduen and Bech-Hanssen while Passing-Bablok non-parametric analysis revealed significant systematic biases all four PAMP-DE estimates. There was poor agreement between PAMP-RHC measures and PAMP-DE deciles (Kappa values were 0.112, 0.097, 0.095, and 0.121, respectively). This study showed a poor agreement between PAMP-DE estimates by four TR-derived formulae and PAMP-RHC in patients with PH, regardless of the etiology. However, these results can not be fully extrapolated to a normal population and did not address the reliability of DE estimates for PH screening procedures
%K pulmonary hypertension
%K pulmonary artery pressure
%K echocardiography
%K right heart catheterization
%K agreement
%U https://journals.sagepub.com/doi/full/10.1177/2045894018762270