Reappraisal of echocardiographic algorithm in predicting the pulmonary hypertension redefined by updated pulmonary artery mean pressure treshold

• Published in: European heart journal Vol. 43; no. Supplement_2
• Main Authors: Tanyeri, S, Tokgoz, H C, Karagoz, A, Akbal, O Y, Keskin, B, Kultursay, B, Hakgor, A, Kulahcioglu, Ş, Ceneli, D, Tosun, A, Efe, S C, Bayram, Z, Tanboga, I H, Ozdemir, N, Kaymaz, C
• Format: Journal Article
• Language: English
• Published: 03.10.2022
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1093/eurheartj/ehac544.1877

Abstract Background Although an adopted echocardiography algorithm based on tricuspid regurgitation jet peak velocity (TRVmax) and suggestive findings (SF) for pulmonary hypertension (PH) has been utilized in the non-invasive prediction of PH probability, reliability of this approach for updated hemodynamic definition of PH remains to be determined. Aims In this study, first time, we aimed to evaluate the TRVmax and SF in predicting the probability of PH as defined by mean pulmonary arterial pressure (mPAP) >20 mm Hg and mPAP >25 mm Hg, respectively. Methods Our study group comprised of the retrospectively evaluated 1300 patients (age 53.1±18.8 years, female 62.1%) who underwent right heart catheterisation (RHC) with different indications between 2006 and 2018. All echocardigraphic and RHC assessments were performed in accordance with European Society of Cardiology (ESC)/European Respiratory Society (ERS) 2015 PH Guidelines. Results Although TRVmax showed a significant relation with mPAP in both definitions, SF offered significant contribution for only in predicting mPAP >25 mm Hg, but not for mPAP >20 mm Hg. In predicting the mPAP >20 mm Hg TR Vmax and SF showed odds ratio (OR) of 2.57 (1.59–4.14, p<0.001) and OR of 1.25 (0.86–1.82, p=0.16), respectively (Table 1). In predicting the mPAP >25 mm Hg, TR Vmax and SF showed OR of 2.33 (1.80–3.04, p<0.001) and OR of 1.54 (1.15–2.08, p<0.001), respectively (Table 1). The TRVmax >2.8 m/sec and TRVmax >3.4 m/sec were associated with 70% and 84% probability of mPAP >20 mm Hg, and 60% and 76% probability of mPAP >25 mm Hg, respectively (Figure 1). Conclusions In contrast to those in predicting the mPAP >25 mm Hg, SF did not provide a significant contribution to probability of mPAP >20 mm Hg predicted by TRVmax solely. The impact of the novel mPAP treshold on echocardiographic prediction of PH remains to be clarifed by future studies. Funding Acknowledgement Type of funding sources: None.