Accuracy of pulmonary artery systolic pressure estimated by transthoracic echocardiography

Abstract:

Objective：To investigate the accuracy of pulmonary artery systolic pressure（PASP） estimated by transthoracic echocardiog－raphy（TTE） using tricuspid regurgitation pressure gradient measurements. Methods：A cohort of 91 patients who were hospitalized in the First Affiliated Hospital of Chongqing Medical University between October 2015 and December 2016 with suspected pulmonary hypertension（PH） were enrolled in the retrospective study. All the patients underwent TTE and right heart catheterization（RHC） ex－aminations. Setting the RHC results as the golden standard，the correlation between two examinations was evaluated using Pearson analytic method. The receiver operating characteristic（ROC） curve was drawn in order to analyze the accuracy of TTE and clarified its cut-off value for PH screening. Results：TTE confirmed 67 patients a diagnosis of PH with a diagnostic rate of 73.6%. The mean estimated PASP by TTE and RHC were （73.63±23.96） mmHg and （52.91±3.07） mmHg，respectively. Pearson correlation analysis showed that there was a moderate correlation between two methods（r=0.734，P=0.000）. Area under the ROC curve was 0.812（P=0.000），indicating the diagnosis accuracy was moderate. The cut-off value for diagnosis of PH was PASP≥62.5 mmHg （sensitivity：70%，specificity：83%） which was higher than current international standard. Conclusion：The evaluation of PASP estimated by TTE using tricuspid regurgitation pressure gradient measurements is inaccurate；it is more likely to overestimate the PASP.