More on the noninvasive diagnosis of pulmonary hypertension: Doppler echocardiography revisited.

The noninvasive diagnosis of pulmonary hypertension generally includes a physical examination, an electrocardiogram, a chest roentgenogram, a radionuclide angiography, and an echocardiography. These methods can discriminate mild from severe elevation in pressure, but lack sufficient sensitivity to be useful in the evaluation of short-term therapeutic interventions or in the monitoring of the clinical course of patients [1, 2]. Advances in echo-Doppler technology in the years since 1980 have made it possible to improve the estimation of pulmonary artery pressures (Ppa) and pulmonary vascular resistance (PVR) by the study of tricuspid regurgitation (TR) jets and pulmonary flow-velocity waves [3]. The echoDoppler evaluation of pulmonary hypertension has since entered routine cardiological practice, but is still considered inferior to a right heart catheterization [4, 5]. This opinion may be based on an insufficient appreciation of the information content of the Doppler recordings.