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A new method to estimate pulmonary vascular resistance using diastolic pulmonary artery-right ventricular pressure gradients derived from continuous-wave Doppler velocity measurements of pulmonary regurgitation

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Please use this identifier to cite or link to this item:http://hdl.handle.net/2115/68252

Title: A new method to estimate pulmonary vascular resistance using diastolic pulmonary artery-right ventricular pressure gradients derived from continuous-wave Doppler velocity measurements of pulmonary regurgitation
Authors: Kaga, Sanae Browse this author
Mikami, Taisei Browse this author →KAKEN DB
Murayama, Michito Browse this author
Okada, Kazunori Browse this author
Masauzi, Nobuo Browse this author
Nakabachi, Masahiro Browse this author
Nishino, Hisao Browse this author
Yokoyama, Shinobu Browse this author
Nishida, Mutsumi Browse this author →KAKEN DB
Hayashi, Taichi Browse this author
Murai, Daisuke Browse this author
Iwano, Hiroyuki Browse this author →KAKEN DB
Sakakibara, Mamoru Browse this author
Yamada, Satoshi Browse this author →KAKEN DB
Tsutsui, Hiroyuki Browse this author →KAKEN DB
Keywords: Pulmonary vascular resistance
Echocardiography
Pulmonary regurgitation
Left heart failure
Issue Date: Jan-2017
Publisher: Springer
Journal Title: International journal of cardiovascular imaging
Volume: 33
Issue: 1
Start Page: 31
End Page: 38
Publisher DOI: 10.1007/s10554-016-0965-2
PMID: 27576320
Abstract: Pulmonary vascular resistance (PVR) is an important hemodynamic parameter in patients with heart failure, especially when the pulmonary arterial pressure is lower due to reduced stroke volume. Several echocardiographic methods to estimate PVR have been proposed, but their applications in patients with organic left-sided heart diseases have been limited. The aim of the present study was to examine the usefulness of our new method to estimate PVR (PVRPR) based on the continuous-wave Doppler velocity measurements of pulmonary regurgitation in these patients. In 43 patients who underwent right heart catheterization, PVRPR was calculated as the difference between the Doppler-derived early- and end-diastolic pulmonary artery (PA)-right ventricular (RV) pressure gradients divided by the cardiac output measured in the left ventricular outflow tract by echocardiography. The PVRPR correlated well with invasive PVR (PVRCATH) (r = 0.81, p < 0.001) without any fixed bias in Bland-Altman analysis. The conventional echocardiographic PVRs showed inadequate correlations with PVRCATH, or a obvious overestimation of PVRCATH. In the receiver operating characteristic analyses to determine the patients with abnormal elevation of PVRCATH (> 3 Wood units, WU), the area under the curve was the greatest for PVRPR (0.964) compared to the conventional PVRs (0.649-0.839). PVRPR had 83 % sensitivity and 100 % specificity at the optimal cut-off value of 3.10 WU in identifying patients with PVRCATH > 3 WU. Our simple and theoretical PVRPR is useful for the noninvasive estimation of PVR.
Rights: This is a post-peer-review, pre-copyedit version of an article published in International journal of cardiovascular imaging. The final authenticated version is available online at: http://dx.doi.org/10.1007/s10554-016-0965-2
Type: article (author version)
URI: http://hdl.handle.net/2115/68252
Appears in Collections:保健科学院・保健科学研究院 (Graduate School of Health Sciences / Faculty of Health Sciences) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 加賀 早苗

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