Loading ...
Sorry, an error occurred while loading the content.
 

[echocardiography] Pulmonary Hypertension

Expand Messages
  • Daniel Shindler
    Question to the group: What parameters (if any) in the pulmonary artery pulsed wave Doppler have you actually found useful in following chronic pulmonary
    Message 1 of 3 , Jul 2, 1998
      Question to the group:

      What parameters (if any) in the pulmonary artery pulsed wave Doppler
      have you actually found useful in following chronic pulmonary
      hypertension?

      How often is time-to-peak useful?

      Mid systolic slowing....?

      Dan Shindler


      ------------------------------------------------------------------------
      TITLE:
      Inaccuracy of Doppler estimates of pulmonary artery
      pressure
      using pulmonary flow acceleration time.
      AUTHOR:
      Nanna M; Lin SL; Tak T; McKay C; Meltzer RS; Rahimtoola
      SH; Chandraratna PA
      AUTHOR
      AFFILIATION:
      Department of Medicine, LAC-USC Medical Center,
      University of
      Southern California School of Medicine.
      SOURCE:
      Can J Cardiol 1990 Jan-Feb;6(1):19-23
      NLM CIT. ID:
      90182332
      ABSTRACT:
      Pulsed Doppler echocardiography was used to estimate
      mean
      pulmonary artery pressure (PAP), mean pulmonary artery
      wedge
      pressure PAWP) and the changes in PAP and PAWP
      following
      intervention in an unselected population composed of 60
      patients
      undergoing routine diagnostic cardiac catheterization.
      Simultaneous Doppler and strain gauge manometry
      recordings of
      PAP and PAWP were interpreted by independent observers
      in a
      blinded fashion. A first set of measurements was
      obtained before
      left ventricular angiography and a second soon after
      the injection
      of contrast dye. The mean Doppler PAP and PAWP were
      derived
      from acceleration time and calculated using previously
      published
      regression equations: PAP = -0.45 x AcT + 79, PAWP = 57
      - 0.39 x
      AcT. At rest, PAP measurements by strain gauge
      manometry
      ranged from 13 to 45 mmHg with a mean of 24 +/- 10 (one
      standard
      deviation); PAWP ranged from 2 to 40 mmHg with a mean
      of 15 +/-
      6. Following left ventricular angiography, the PAP
      ranged from 18
      to 50 mmHg with a mean of 29 +/- 7; PAWP ranged from 6
      to 45
      mmHg with a mean of 20 +/- 7. The values obtained by
      pulsed
      Doppler before and after intervention correlated poorly
      with those
      obtained by strain gauge manometry (r = 0.09 and 0.26
      for PAP; r
      = 0.03 and 0.25 for PAWP).(ABSTRACT TRUNCATED AT 250


      ----------------------------------------------------------------------


      The pulmonary artery acceleration time determined with the
      MR-RACE-technique: comparison to pulmonary artery mean
      pressure in 12 patients.
      AUTHOR:
      Wacker CM; Schad LR; Gehling U; Gamroth AH; Muller E;
      Knopp MV; Schulz V; van Kaick G
      AUTHOR
      AFFILIATION:
      Department of Radiological Diagnostics and Therapy,
      German
      Cancer Research Center (DKFZ), Heidelberg.
      SOURCE:
      Magn Reson Imaging 1994;12(1):25-31
      NLM CIT. ID:
      94125914
      ABSTRACT:
      The goal of our study was to evaluate a rapid
      noninvasive MR
      technique for quantification of the pulmonary artery
      acceleration
      time (PAT) and other parameters of pulmonary
      hemodynamics and
      to correlate with pulmonary artery mean pressure
      (mPAP). The
      PAT known as "time-to-peak" out of Doppler
      echocardiographic
      measurements normally shows significant inverse
      correlation with
      mPAP. With the MR-RACE-Technique (RACE: Real time
      ACquisition and Evaluation of motion) blood velocity
      measurements
      can be obtained with a total acquisition time of a few
      seconds. The
      application of this technique to the pulmonary artery
      has not been
      reported before. Out of the RACE velocity wave form PAT
      can be
      obtained with a temporal resolution of about 15 ms. To
      explore the
      relationship between PAT and mPAP, right heart
      catheterization
      and MR-RACE measurements were performed in 12 patients
      with
      different pulmonary vascular abnormalities. Results of
      MR-RACE
      were compared with those of mPAP measured by right
      heart
      catheter and showed significant inverse correlation (r
      = -0.82, p =
      .0011, n = 12). The ability of MR-RACE to enable
      measurements of
      blood flow with profiles may be important for
      characterizing
      pulmonary and cardiovascular abnormalities.

      ---------------------------------------------------------------------

      Effects of heart rate and pulmonary artery pressure on
      Doppler
      pulmonary artery acceleration time in experimental acute
      pulmonary
      hypertension.
      AUTHOR:
      Mallery JA; Gardin JM; King SW; Ey S; Henry WL
      AUTHOR
      AFFILIATION:
      Division of Cardiology, University of California Irvine,
      Orange
      92668.
      SOURCE:
      Chest 1991 Aug;100(2):470-3
      NLM CIT. ID:
      91323103
      ABSTRACT:
      Chronic pulmonary hypertension in humans is
      characterized by
      shortening of the pulmonary artery acceleration time as
      measured
      by Doppler echocardiography, such that the higher the
      pulmonary
      artery pressure, the shorter the pulmonary acceleration
      time.
      Increases in heart rate are also known to produce
      decreases in the
      pulmonary artery acceleration time. To explore the
      relationship
      between mean pulmonary artery pressure, heart rate, and
      Doppler
      pulmonary artery acceleration time, experimental acute
      pulmonary
      hypertension was created in nine Duroc swine, either by
      infusion of
      Sephadex beads with embolization of the pulmonary
      arterial
      circulation or by partially occluding the main pulmonary
      artery 8 to
      10 cm distal to the pulmonic valve. Pulmonary artery
      Doppler flow
      velocity recordings and invasive pressure measurements
      were made
      at baseline and at paced atrial rates ranging from 60 to
      160 beats
      per minute, in 20-beat increments. The results in this
      acute animal
      model reveal that increases in heart rate produced
      significant
      decreases in Doppler pulmonary artery acceleration time
      at mean
      pressures below 25 mm Hg. However, with mean pulmonary
      artery
      pressures greater than 25 mm Hg, both heart rate and
      increases in
      pulmonary artery pressure had no significant effect on
      acceleration
      time.





      ----------------------------------------------------------------------
      TITLE:
      Effect of acute changes in heart rate on Doppler
      pulmonary artery
      acceleration time in a porcine model.
      AUTHOR:
      Gardin JM; Sato DA; Rohan MK; Shu VW; Allfie A; Gardin
      SK;
      Henry WL
      AUTHOR
      AFFILIATION:
      Department of Medicine, University of California Irvine
      Medical
      Center, Orange 92668.
      SOURCE:
      Chest 1988 Nov;94(5):994-7
      NLM CIT. ID:
      89030043
      ABSTRACT:
      Doppler measurements of pulmonary artery (PA)
      acceleration time
      (AT) have been used clinically to estimate PA pressure.
      However,
      these studies have been performed primarily in patients
      without
      tachycardia. To determine the effect of acute changes
      in heart rate
      on PA AT, atrial pacing studies were performed in seven
      closed-chest pigs. Pulsed Doppler PA flow velocity
      recordings were
      obtained from a parasternal position at pacing rates
      from 100 to
      140 beats/min. PA pressure remained constant (mean +/-
      SD = 14
      +/- 5 mm Hg) over the entire range of paced rates. When
      PA
      Doppler measurements were compared at heart rates of
      100 and
      140 beats/min, there were decreases at the higher heart
      rate in
      both acceleration time (110 +/- 12 vs 83 +/- 11 ms, p
      less than 0.01)
      and ejection time (ET) (315 +/- 23 vs 237 +/- 21 ms, p
      less than
      0.01). In contrast, there was no change in either PA
      peak flow
      velocity (69 +/- 15 vs 62 +/- 18 cm/s) or the ratio of
      AT/ET (0.35 +/-
      .02 vs. .36 +/- .03). Consequently, when estimating PA
      pressure in
      states of tachycardia, the PA AT/ET ratio may be a more
      useful
      measurement than PA acceleration time.

      ------------------------------------------------------------------------
      TITLE:
      [Flow velocity and acceleration in the
      pulmonary artery
      of the dog]
      AUTHOR:
      Fricke GR; Scheu HD; Simon H
      SOURCE:
      Basic Res Cardiol 1973 Mar-Apr;68(2):108-22


      ****************************************************
      Daniel Shindler, M.D.
      University of Medicine and Dentistry of New Jersey
      ****************************************************
      e-mail:...........................shindler@...
      home page: http://www2.umdnj.edu/~shindler/


      ----
      Read this list on the Web at http://www.FindMail.com/list/echocardiography/
      To unsubscribe, email to echocardiography-unsubscribe@...
      To subscribe, email to echocardiography-subscribe@...
      --
      Start a FREE E-Mail List at http://makelist.com !
    • Michael Roy Smith
      In my experience, the values derived from pulmonary flow acceleration time are unreliable. In the follow-up of patients with chronic [pulmonary hypertension we
      Message 2 of 3 , Jul 3, 1998
        In my experience, the values derived from pulmonary flow acceleration
        time are unreliable. In the follow-up of patients with chronic
        [pulmonary hypertension we use the pulmonary artery sistolic
        pressure, derived from tricuspid regurgitation. This method has been
        validated by simultaneous measurements at the ICU on patients with
        Swan-Ganz catheters.
        Michael Roy Smith, M.D.
        Echocardiography
        Hospital Israelita Albert Einstein
        Av. Albert Einstein, 701 s. 473
        Sao Paulo - SP - Brazil
        tel. 55-11-845-0429
        fax. 55-11-8450415


        ----
        Read this list on the Web at http://www.FindMail.com/list/echocardiography/
        To unsubscribe, email to echocardiography-unsubscribe@...
        To subscribe, email to echocardiography-subscribe@...
        --
        Start a FREE E-Mail List at http://makelist.com !
      • tvakani@netcom.ca
        We have found RVSP from Tr jet very useful im making clinical decisions dr. T.Vakani ... Read this list on the Web at
        Message 3 of 3 , Jul 4, 1998
          We have found RVSP from Tr jet very useful im making clinical decisions

          dr. T.Vakani


          ----
          Read this list on the Web at http://www.FindMail.com/list/echocardiography/
          To unsubscribe, email to echocardiography-unsubscribe@...
          To subscribe, email to echocardiography-subscribe@...
          --
          Start a FREE E-Mail List at http://makelist.com !
        Your message has been successfully submitted and would be delivered to recipients shortly.