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Overestimation by echocardiography of the peak systolic pressure gradient between the right ventricle and right atrium due to tricuspid regurgitation and the usefulness of the early diastolic transpulmonary valve pressure gradient for estimating pulmonary artery pressure

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Title: Overestimation by echocardiography of the peak systolic pressure gradient between the right ventricle and right atrium due to tricuspid regurgitation and the usefulness of the early diastolic transpulmonary valve pressure gradient for estimating pulmonary artery pressure
Authors: Hioka, Takuma Browse this author
Kaga, Sanae Browse this author
Mikami, Taisei Browse this author →KAKEN DB
Okada, Kazunori Browse this author
Murayama, Michito 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
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: Echocardiography
Pulmonary artery pressure
Tricuspid regurgitation
Pulmonary regurgitation
Issue Date: Jul-2017
Publisher: Springer
Journal Title: Heart and vessels
Volume: 32
Issue: 7
Start Page: 833
End Page: 842
Publisher DOI: 10.1007/s00380-016-0929-4
PMID: 27999948
Abstract: We investigated the influence of tricuspid regurgitation (TR) severity on the echocardiographic peak systolic transtricuspid pressure gradient (TRPG) and evaluated the usefulness of the peak early diastolic transpulmonary valve pressure gradient (PRPG) for estimating pulmonary artery (PA) pressure. In 55 consecutive right heart-catheterized patients, we measured the peak systolic right ventricular (RV)-right atrial (RA) pressure gradient (RV-RA(CATH)), peak early diastolic PA-RV pressure gradient (PA-RVCATH), and mean PA pressure (MPAP(CATH)). Using echocardiography, we obtained the TRPG, PRPG, and an estimate of the mean PA pressure (EMPAP) as the sum of PRPG and the estimated RA pressure, and measured the vena contracta width of TR (VCTR). The difference between the TRPG and RV-RA(CATH) was significantly greater in the very severe TR group (VCTR > 11 mm) than in the mild, moderate, and severe TR groups, and significantly greater in the severe TR group (7 < VCTR ae<currency> 11 mm) than in the mild TR group. The overestimation of the pressure gradient > 10 mmHg by TRPG was not seen in the mild or moderate TR groups, but was observed in the severe and very severe TR groups (22 and 83%, respectively). In the ROC analysis, EMPAP could distinguish patients with MPAP(CATH) ae<yen> 25 mmHg with the area under the curve of 0.93, 100% sensitivity, and 87% specificity. In conclusion, TRPG frequently overestimated RV-RA(CATH) when VCTR was > 11 mm and sometimes did when VCTR was > 7 mm, where EMPAP using PRPG was useful for estimating PA pressure.
Rights: The final publication is available at Springer via http://dx.doi.org/10.1007/ s00380-016-0929-4
Type: article (author version)
URI: http://hdl.handle.net/2115/71155
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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: 樋岡 拓馬

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