Accuracy of Tissue Doppler Estimation of the Right Atrial Pressure in Anesthetized, Paralyzed, and Mechanically Ventilated Patients

• Published in: The American journal of cardiology Vol. 97; no. 11; pp. 1654 - 1656
• Main Authors: Michaux, Isabelle, Filipovic, Miodrag, Skarvan, Karl, Schneiter, Stephan, Seeberger, Manfred D.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.06.2006; Elsevier; Elsevier Limited
• Subjects: Anesthesia, General - methods; Biological and medical sciences; Cardiology. Vascular system; Coronary Artery Bypass; Echocardiography, Doppler; Female; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Humans; Male; Measurement techniques; Medical sciences; Middle Aged; Monitoring, Intraoperative; Muscle Relaxants, Central - pharmacology; Myocardial Infarction - diagnostic imaging; Myocardial Infarction - physiopathology; Myocardial Infarction - surgery; Paralysis - chemically induced; People with disabilities; Ratios; Regression analysis; Reproducibility of Results; Respiration, Artificial; Ultrasonic imaging; Ventricular Pressure - physiology; Sonography; Doppler ultrasound study; Human; Accuracy; Estimation; Tissue doppler; Circulatory system; Cardiology; Right atrium; Phlebology; Pressure
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2005.12.061

The ratio of tricuspid peak early inflow velocity to peak early diastolic velocity of the lateral tricuspid annulus (the E/Ea ratio) measured by transthoracic echocardiography has been reported to correlate with right atrial (RA) pressure. In this study, the correlation between the E/Ea ratio and RA pressure was tested in 44 anesthetized, paralyzed, and mechanically ventilated patients by transesophageal echocardiography. Mean RA pressure and the following echocardiographic data were recorded simultaneously: tricuspid peak early inflow velocities by Doppler echocardiography, peak early diastolic velocity of the lateral tricuspid annulus by tissue Doppler imaging, and right ventricular and left ventricular end-diastolic areas. Linear regression did not indicate a correlation between the E/Ea ratio and RA pressure (r = −0.11, p = 0.48) or between the E/Ea ratio and the right or left ventricular end-diastolic area index; it revealed a weak correlation between RA pressure and the inspiratory plateau pressure and body mass index. In conclusion, the E/Ea ratio failed to predict RA pressure or planimetric indexes of ventricular preload in anesthetized, paralyzed, and mechanically ventilated patients. In these patients, RA pressure was largely influenced by extracardiac factors.