Noninvasive assessment of elevated pulmonary vascular resistance in children with pulmonary hypertension secondary to congenital heart disease : A comparative study between five different Doppler indices

BACKGROUND: Pulmonary vascular resistance (PVR) is an important hemodynamic parameter in patients with congenital heart disease (CHD). Noninvasive estimation of PVR represents an attractive alternative to invasive measurements

Bibliographische Detailangaben
Veröffentlicht in:Journal of the Saudi Heart Association. - 1999. - 24(2012), 4 vom: 03. Okt., Seite 233-41
1. Verfasser: Roushdy, Alaa Mahmoud (VerfasserIn)
Weitere Verfasser: Ragab, Iman, Abd El Raouf, Wessam
Format: Online-Aufsatz
Sprache:English
Veröffentlicht: 2012
Zugriff auf das übergeordnete Werk:Journal of the Saudi Heart Association
Schlagworte:Journal Article AcT, acceleration time AcTc, acceleration time corrected to heart rate BSA, body surface area CHD, congenital heart disease Congenital heart disease DTI, Doppler tissue imaging Doppler InT, inflection time InTc, inflection time corrected to heart rate mehr... MPAP, mean pulmonary artery pressure Noninvasive PA, pulmonary artery PCWP, pulmonary capillary wedge pressure PH, pulmonary hypertension PVR, pulmonary vascular resistance Pulmonary vascular resistance Qp, pulmonary blood flow ROC, receiver operating characteristics curves RVSP, right ventricular systolic pressure TRV, peak tricuspid regurgitant velocity TSm, peak velocity of tricuspid annular systolic motion TVIRVOT, right ventricular outflow tract time–velocity integral
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100 1 |a Roushdy, Alaa Mahmoud  |e verfasserin  |4 aut 
245 1 0 |a Noninvasive assessment of elevated pulmonary vascular resistance in children with pulmonary hypertension secondary to congenital heart disease  |b A comparative study between five different Doppler indices 
264 1 |c 2012 
336 |a Text  |b txt  |2 rdacontent 
337 |a ƒaComputermedien  |b c  |2 rdamedia 
338 |a ƒa Online-Ressource  |b cr  |2 rdacarrier 
500 |a Date Completed 31.10.2013 
500 |a Date Revised 21.10.2021 
500 |a published: Print-Electronic 
500 |a Citation Status PubMed-not-MEDLINE 
520 |a BACKGROUND: Pulmonary vascular resistance (PVR) is an important hemodynamic parameter in patients with congenital heart disease (CHD). Noninvasive estimation of PVR represents an attractive alternative to invasive measurements 
520 |a METHODS: The study included 175 patients with pulmonary hypertension (PH) secondary to CHD. All patients underwent full echocardiographic study and invasive hemodynamic measurements. The study population was then subdivided into four subgroups. Each of the following Doppler indices was measured in one of these four subgroups: peak tricuspid regurgitant velocity (TRV), the ratio of the TRV to the velocity time integral of the right ventricular outflow tract (TRV/TVIRVOT), peak velocity of tricuspid annular systolic motion (TSm), heart rate corrected acceleration time and infliction time of the proximal left pulmonary artery (ATc, InTc). The data obtained was correlated with invasive PVR measurement. An ROC curve analysis was done to generate cutoff points with the highest balanced sensitivity and specificity to predict PVR > 6WU/m(2). The receiver operating characteristics (ROC) curves were compared with each other to determine the most reliable cutoff point in predicting elevated PVR > 6WU/m(2) 
520 |a RESULTS: There was a significant correlation between both the TRV and TSm and invasive measurement of PVR (r = -0.511, 0.387 and P value = 0.0002, 0.006 respectively). The TSm and TRV cutoff values were the most reliable to predict elevated PVR > 6 WU/m(2). A TSm cutoff value of ⩽16.16 cm/s provided the best balanced sensitivity (85.7%) and specificity (66.7%) to determine PVRCATH > 6 WU/m(2). A cutoff value less than 7.62 cm/s had 100% specificity to predict PVRCATH > 6 WU/m(2). A TRV cutoff value of >3.96 m/s provided the best balanced sensitivity (66.7%) and specificity (100%) to determine PVRCATH > 6 WU/m(2). Both TRV and TSm had the highest area under the ROC curve among the 5 DOPPLER indices studied 
520 |a CONCLUSION: Prediction of elevated PVR in children with PH secondary to CHD could be achieved noninvasively using a number of Doppler indices. Among the five Doppler indices examined in the current study, the peak TRV and the TSm of the lateral tricuspid annulus had the highest balanced sensitivity and specificity to predict PVRI > 6 WU/m(2) 
650 4 |a Journal Article 
650 4 |a AcT, acceleration time 
650 4 |a AcTc, acceleration time corrected to heart rate 
650 4 |a BSA, body surface area 
650 4 |a CHD, congenital heart disease 
650 4 |a Congenital heart disease 
650 4 |a DTI, Doppler tissue imaging 
650 4 |a Doppler 
650 4 |a InT, inflection time 
650 4 |a InTc, inflection time corrected to heart rate 
650 4 |a MPAP, mean pulmonary artery pressure 
650 4 |a Noninvasive 
650 4 |a PA, pulmonary artery 
650 4 |a PCWP, pulmonary capillary wedge pressure 
650 4 |a PH, pulmonary hypertension 
650 4 |a PVR, pulmonary vascular resistance 
650 4 |a Pulmonary vascular resistance 
650 4 |a Qp, pulmonary blood flow 
650 4 |a ROC, receiver operating characteristics curves 
650 4 |a RVSP, right ventricular systolic pressure 
650 4 |a TRV, peak tricuspid regurgitant velocity 
650 4 |a TSm, peak velocity of tricuspid annular systolic motion 
650 4 |a TVIRVOT, right ventricular outflow tract time–velocity integral 
700 1 |a Ragab, Iman  |e verfasserin  |4 aut 
700 1 |a Abd El Raouf, Wessam  |e verfasserin  |4 aut 
773 0 8 |i Enthalten in  |t Journal of the Saudi Heart Association  |d 1999  |g 24(2012), 4 vom: 03. Okt., Seite 233-41  |w (DE-627)NLM098225227  |x 1016-7315  |7 nnns 
773 1 8 |g volume:24  |g year:2012  |g number:4  |g day:03  |g month:10  |g pages:233-41 
856 4 0 |u http://dx.doi.org/10.1016/j.jsha.2012.05.004  |3 Volltext 
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