Non-invasive estimation of pulmonary vascular resistance in patients of pulmonary hypertension in congenital heart disease with unobstructed pulmonary flow

Arindam Pande, Achyut Sarkar, Imran Ahmed, Naveen Chandra, Shailesh Kumar Patil, Chanchal Kumar Kundu, Rahul Arora, Ajanta Samanta

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Context: Pulmonary vascular resistance (PVR) is a critical and essential parameter during the assessment and selection of modality of treatment in patients with congenital heart disease accompanied by pulmonary arterial hypertension. Aim: The present study was planned to evaluate non-invasive echocardiographic parameters to assess pulmonary vascular resistance. Settings and Design: This prospective observational study included 44 patients admitted in the cardiology and pediatric cardiology ward of our institution for diagnostic or pre-operative catheter based evaluation of pulmonary arterial pressure and PVR. Materials and Methods: Detailed echocardiographic evaluation was carried out including tricuspid regurgitation velocity (TRV) and velocity time integral of the right-ventricular outflow tract (VTIRVOT ). These parameters were correlated with catheter-based measurements of PVR. Results: The TRV/VTIRVOT ratio correlated well with PVR measured at catheterization (PVRcath) (r = 0.896, 95% confidence interval [CI] 0.816 to 0.9423, P < 0.001). Using the Bland-Altman analysis, PVR measurements derived from Doppler data showed satisfactory limits of agreement with catheterization estimated PVR. For a PVR of 6 Wood units (WU), a TRV/VTIRVOT value of 0.14 provided a sensitivity of 96.67% and a specificity of 92.86% (area under the curve 0.963, 95% confidence interval 0.858 to 0.997) and for PVR of 8 WU a TRV/VTIRVOT value of 0.17 provided a sensitivity of 79.17% and a specificity of 95% (area under the curve 0. 0.923, 95% confidence interval 0.801 to 0.982). Conclusions: Doppler-derived ratio of TRV/VTIRVOT is a simple, non-invasive index, which can be used to estimate PVR.

Original languageEnglish
Pages (from-to)92-97
Number of pages6
JournalAnnals of Pediatric Cardiology
Volume7
Issue number2
DOIs
Publication statusPublished - 01-01-2014
Externally publishedYes

Fingerprint

Pulmonary Hypertension
Vascular Resistance
Heart Diseases
Tricuspid Valve Insufficiency
Lung
Confidence Intervals
Cardiology
Catheterization
Area Under Curve
Catheters
Observational Studies
Arterial Pressure
Prospective Studies
Pediatrics

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

Cite this

Pande, Arindam ; Sarkar, Achyut ; Ahmed, Imran ; Chandra, Naveen ; Patil, Shailesh Kumar ; Kundu, Chanchal Kumar ; Arora, Rahul ; Samanta, Ajanta. / Non-invasive estimation of pulmonary vascular resistance in patients of pulmonary hypertension in congenital heart disease with unobstructed pulmonary flow. In: Annals of Pediatric Cardiology. 2014 ; Vol. 7, No. 2. pp. 92-97.
@article{78499df4986a467c9d4c2fedd7a0c5b9,
title = "Non-invasive estimation of pulmonary vascular resistance in patients of pulmonary hypertension in congenital heart disease with unobstructed pulmonary flow",
abstract = "Context: Pulmonary vascular resistance (PVR) is a critical and essential parameter during the assessment and selection of modality of treatment in patients with congenital heart disease accompanied by pulmonary arterial hypertension. Aim: The present study was planned to evaluate non-invasive echocardiographic parameters to assess pulmonary vascular resistance. Settings and Design: This prospective observational study included 44 patients admitted in the cardiology and pediatric cardiology ward of our institution for diagnostic or pre-operative catheter based evaluation of pulmonary arterial pressure and PVR. Materials and Methods: Detailed echocardiographic evaluation was carried out including tricuspid regurgitation velocity (TRV) and velocity time integral of the right-ventricular outflow tract (VTIRVOT ). These parameters were correlated with catheter-based measurements of PVR. Results: The TRV/VTIRVOT ratio correlated well with PVR measured at catheterization (PVRcath) (r = 0.896, 95{\%} confidence interval [CI] 0.816 to 0.9423, P < 0.001). Using the Bland-Altman analysis, PVR measurements derived from Doppler data showed satisfactory limits of agreement with catheterization estimated PVR. For a PVR of 6 Wood units (WU), a TRV/VTIRVOT value of 0.14 provided a sensitivity of 96.67{\%} and a specificity of 92.86{\%} (area under the curve 0.963, 95{\%} confidence interval 0.858 to 0.997) and for PVR of 8 WU a TRV/VTIRVOT value of 0.17 provided a sensitivity of 79.17{\%} and a specificity of 95{\%} (area under the curve 0. 0.923, 95{\%} confidence interval 0.801 to 0.982). Conclusions: Doppler-derived ratio of TRV/VTIRVOT is a simple, non-invasive index, which can be used to estimate PVR.",
author = "Arindam Pande and Achyut Sarkar and Imran Ahmed and Naveen Chandra and Patil, {Shailesh Kumar} and Kundu, {Chanchal Kumar} and Rahul Arora and Ajanta Samanta",
year = "2014",
month = "1",
day = "1",
doi = "10.4103/0974-2069.132475",
language = "English",
volume = "7",
pages = "92--97",
journal = "Annals of Pediatric Cardiology",
issn = "0974-2069",
publisher = "Medknow Publications and Media Pvt. Ltd",
number = "2",

}

Non-invasive estimation of pulmonary vascular resistance in patients of pulmonary hypertension in congenital heart disease with unobstructed pulmonary flow. / Pande, Arindam; Sarkar, Achyut; Ahmed, Imran; Chandra, Naveen; Patil, Shailesh Kumar; Kundu, Chanchal Kumar; Arora, Rahul; Samanta, Ajanta.

In: Annals of Pediatric Cardiology, Vol. 7, No. 2, 01.01.2014, p. 92-97.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Non-invasive estimation of pulmonary vascular resistance in patients of pulmonary hypertension in congenital heart disease with unobstructed pulmonary flow

AU - Pande, Arindam

AU - Sarkar, Achyut

AU - Ahmed, Imran

AU - Chandra, Naveen

AU - Patil, Shailesh Kumar

AU - Kundu, Chanchal Kumar

AU - Arora, Rahul

AU - Samanta, Ajanta

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Context: Pulmonary vascular resistance (PVR) is a critical and essential parameter during the assessment and selection of modality of treatment in patients with congenital heart disease accompanied by pulmonary arterial hypertension. Aim: The present study was planned to evaluate non-invasive echocardiographic parameters to assess pulmonary vascular resistance. Settings and Design: This prospective observational study included 44 patients admitted in the cardiology and pediatric cardiology ward of our institution for diagnostic or pre-operative catheter based evaluation of pulmonary arterial pressure and PVR. Materials and Methods: Detailed echocardiographic evaluation was carried out including tricuspid regurgitation velocity (TRV) and velocity time integral of the right-ventricular outflow tract (VTIRVOT ). These parameters were correlated with catheter-based measurements of PVR. Results: The TRV/VTIRVOT ratio correlated well with PVR measured at catheterization (PVRcath) (r = 0.896, 95% confidence interval [CI] 0.816 to 0.9423, P < 0.001). Using the Bland-Altman analysis, PVR measurements derived from Doppler data showed satisfactory limits of agreement with catheterization estimated PVR. For a PVR of 6 Wood units (WU), a TRV/VTIRVOT value of 0.14 provided a sensitivity of 96.67% and a specificity of 92.86% (area under the curve 0.963, 95% confidence interval 0.858 to 0.997) and for PVR of 8 WU a TRV/VTIRVOT value of 0.17 provided a sensitivity of 79.17% and a specificity of 95% (area under the curve 0. 0.923, 95% confidence interval 0.801 to 0.982). Conclusions: Doppler-derived ratio of TRV/VTIRVOT is a simple, non-invasive index, which can be used to estimate PVR.

AB - Context: Pulmonary vascular resistance (PVR) is a critical and essential parameter during the assessment and selection of modality of treatment in patients with congenital heart disease accompanied by pulmonary arterial hypertension. Aim: The present study was planned to evaluate non-invasive echocardiographic parameters to assess pulmonary vascular resistance. Settings and Design: This prospective observational study included 44 patients admitted in the cardiology and pediatric cardiology ward of our institution for diagnostic or pre-operative catheter based evaluation of pulmonary arterial pressure and PVR. Materials and Methods: Detailed echocardiographic evaluation was carried out including tricuspid regurgitation velocity (TRV) and velocity time integral of the right-ventricular outflow tract (VTIRVOT ). These parameters were correlated with catheter-based measurements of PVR. Results: The TRV/VTIRVOT ratio correlated well with PVR measured at catheterization (PVRcath) (r = 0.896, 95% confidence interval [CI] 0.816 to 0.9423, P < 0.001). Using the Bland-Altman analysis, PVR measurements derived from Doppler data showed satisfactory limits of agreement with catheterization estimated PVR. For a PVR of 6 Wood units (WU), a TRV/VTIRVOT value of 0.14 provided a sensitivity of 96.67% and a specificity of 92.86% (area under the curve 0.963, 95% confidence interval 0.858 to 0.997) and for PVR of 8 WU a TRV/VTIRVOT value of 0.17 provided a sensitivity of 79.17% and a specificity of 95% (area under the curve 0. 0.923, 95% confidence interval 0.801 to 0.982). Conclusions: Doppler-derived ratio of TRV/VTIRVOT is a simple, non-invasive index, which can be used to estimate PVR.

UR - http://www.scopus.com/inward/record.url?scp=84901304504&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84901304504&partnerID=8YFLogxK

U2 - 10.4103/0974-2069.132475

DO - 10.4103/0974-2069.132475

M3 - Article

AN - SCOPUS:84901304504

VL - 7

SP - 92

EP - 97

JO - Annals of Pediatric Cardiology

JF - Annals of Pediatric Cardiology

SN - 0974-2069

IS - 2

ER -