Pulmonary arterial wave reflection as a novel estimate of pulmonary vascular resistance

Abstract Funding Acknowledgements Type of funding sources: Public hospital(s). Main source(s): International Medical Research and Development Fund Background Measuring pulmonary vascular resistance (PVR) is essential for diagnosing hypertension. PVR can be estimated from a simple ratio tricuspid regurgitation velocity (TRV) to time-velocity integral flow through right ventricular outflow tract (RVOT) (Abbas equation), but this relationship has been shown unreliable in patients with high PVR. Once elevated, there an increased pressure wave reflected the peripheral artery (PA). We tested hypothesis that assessing PA reflection could alternative method estimating Methods This study recruited 83 (69 ± 14 years old, 44 men), including 41 left-sided heart disease, 23 arterial hypertension 19 chronic thromboembolic was assessed by separating waveform derived Doppler tracing TRV into forward backward (Pf Pb), using profile at RVOT. separation based on concept intensity. Abbas equation. Pb equation were compared correlations direct measurement catheterisation within 48 hours after echocardiography. Results Figure A illustrates Pf waveforms obtained patient mid systole formed late peak waveform. correlated strongly catheter (figure B), whereas underestimated especially when high, resulting moderate correlation C). Receiver-operator characteristic curves showed higher accuracy identifying > 3WU as well 6WU, D E). Conclusions novel echocardiographic helps diagnose severity Figure.