Valvular & structural heart disease
Echocardiographic estimation of pulmonary pressure in patients with severe tricuspid regurgitation
Authors' conclusion
The reliability of the estimation of sPAP in patients with severe TR could be altered by high RAP which cannot be estimated with current thresholds.
Study context
- Population
- Consecutive patients with right heart catheterisation and TTE within 48 hours, University Hospital of Rennes78 with severe tricuspid regurgitation (TR)
- Participants
- 236 patients
- Comparison
- TTE vs right heart catheterisation for systolic pulmonary artery pressure (sPAP)
- Outcome
- Reliability of sPAP assessment by TTE (Lin's concordance coefficient, Bland-Altman analysis)
Methodological detailssingle-centre, consecutive patients
- Single-centre
- Consecutive patients
Performance
As reported in the abstract
Concordance of TTE vs catheterisation sPAP
Lin's concordance coefficient (LCC), total population (95% limits of agreement (LOA) 0.74, 0.84)
0.80
LCC, severe TR (95% LOA 0.49, 0.80), propensity to underestimation by TTE
0.67
Further findings
Independent predictor of sPAP misestimation by TTE: 'V-wave cut-off' sign on continuous-wave Doppler
| OR (95% CI) | P value | ||
|---|---|---|---|
| 'V-wave cut-off' signFound exclusively in severe TR | 3.74 (1.48–9.30) | P < 0.01 | |
| 0.10.31310Odds ratio (log scale) |
sPAP underestimation by TTE with elevated right atrial pressure (RAP)
- Underestimation by TTE of about 8 mmHg
Original publication
Echocardiographic estimation of pulmonary pressure in patients with severe tricuspid regurgitation. Heart. Published 12 October 2023. doi:10.
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