[Doppler echocardiography and hemodynamic parameters in congenital heart disease with increased pulmonary flow].

BACKGROUND The prediction of pulmonary hemodynamic data from non-invasive assessment could exempt some patients with congenital cardiac septal defects from preoperative invasive assessment (catheterization). OBJECTIVE To determine, in simultaneous assessment, whether data obtained from Doppler echocardiography could predict aspects of pulmonary hemodynamics in such patients. METHODS Echocardiographic parameters related to systolic and systemic pulmonary flow and pulmonary venous flow were related to hemodynamic data in 30 consecutive patients with cardiac septal defects (aged 4 months to 58 years, median 2.2 years, mean pulmonary artery pressure between 16 and 93 mmHg). RESULTS The velocity-time integrals of systolic flow in right ventricle outflow tract (VTI RVOT > or = 22 cm) and pulmonary venous flow (VTI VP > or = 20 cm) predicted PVR/SVR <; 0.1 levels (pulmonary vascular resistance and systemic vascular resistance ratio), with a specificity of 0.81 and odds ratio above 1.0. For VTI RVOT > or = 27 cm and VTI PV > 24 cm values, the specificity was higher than 0.90 and odds ratio 2.29 and 4.47 respectively. The ratio between pulmonary and systemic flows (Qp/Qs > 2.89 and > or = 4.0, echocardiographic estimates) was useful in predicting Qp/Qs > 3.0 values through catheterization (specificity of 0.78 and 0.91, odds ratio 1.14 and 2.97, respectively). CONCLUSION In patients with cardiac septal defects, Doppler echocardiography is able to identify those at increased flow and low pulmonary vascular resistance.