ISSN 2149-2263 | E-ISSN 2149-2271
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Reappraisal of the Transthoracic Echocardiographic Algorithm in Predicting Pulmonary Hypertension Redefined by Updated Pulmonary Artery Mean Pressure Threshold [Anatol J Cardiol]
Anatol J Cardiol. 2023; 27(6): 348-359 | DOI: 10.14744/AnatolJCardiol.2023.2435

Reappraisal of the Transthoracic Echocardiographic Algorithm in Predicting Pulmonary Hypertension Redefined by Updated Pulmonary Artery Mean Pressure Threshold

Seda Tanyeri1, Hacer Ceren Tokgöz2, Ali Karagöz2, Özgür Yasar Akbal2, Berhan Keskin2, Barkın Kültürsay2, Aykun Hakgör3, Şeyhmus Külahçıoglu2, Doğancan Çeneli2, Ayhan Tosun2, Süleyman Efe2, Zübeyde Bayram2, Ibrahim Halil Tanboga4, Nihal Özdemir2, Cihangir Kaymaz2
1Department of Cardiology, Kocaeli Derince Training and Research Hospital, Kocaeli, Türkiye
2Department of Cardiology, University of Health Sciences Turkey, Hamidiye Faculty of Medicine, Kartal Koşuyolu Heart Training and Research Hospital, İstanbul, Türkiye
3Department of Cardiology, İstanbul Medipol University, İstanbul, Türkiye
4Department of Cardiology, Nişantaşı University, Hisar Intercontinental Hospital, İstanbul, Türkiye

Background: Although an adopted echocardiography algorithm based on tricuspid regurgitation jet peak velocity and suggestive findings for pulmonary hypertension has been utilized in the non-invasive prediction of pulmonary hypertension probability, the reliability of this approach for the updated hemodynamic definition of pulmonary hypertension remains to be determined. In this study, for the first time, we aimed to evaluate the tricuspid regurgitation jet peak velocity and suggestive findings in predicting the probability of pulmonary hypertension as defined by mean pulmonary arterial pressure > 20 mm Hg and > 25 mm Hg, respectively.

Methods: Our study group was comprised of the retrospectively evaluated 1300 patients (age 53.1 ± 18.8 years, female 62.1%) who underwent right heart catheterization with different indications between 2006 and 2018. All echocardiographic and right heart catheterization assessments were performed in accordance with the European Society of Cardiology/European Respiratory Society 2015 Pulmonary Hypertension Guidelines.

Results: Although tricuspid regurgitation jet peak velocity showed a significant relation with mean pulmonary arterial pressure in both definitions, suggestive findings offered a significant contribution only in predicting mean pulmonary arterial pressure ≥ 25 mm Hg but not for mean pulmonary arterial pressure > 20 mm Hg. In predicting the mean pulmonary arterial pressure > 20 mm Hg, tricuspid regurgitation jet peak velocity and suggestive findings showed an odds ratio of 2.57 (1.59-4.14, P <.001) and 1.25 (0.86-1.82, P =.16), respectively. In predicting the mean pulmonary arterial pressure ≥ 25 mm Hg, tricuspid regurgitation jet peak velocity, and suggestive findings showed an odds ratio of 2.33 (1.80-3.04, P <.001) and 1.54 (1.15-2.08, P <.001), respectively. The tricuspid regurgitation jet peak velocity > 2.8 m/s and tricuspid regurgitation jet peak velocity > 3.4 m/s were associated with 70% and 84% probability of mean pulmonary arterial pressure > 20 mm Hg and 60% and 76% probability of mean pulmonary arterial pressure ≥ 25 mm Hg, respectively.

Conclusions: In contrast to those in predicting the mean pulmonary arterial pressure ≥ 25 mm Hg, suggestive findings did not provide a significant contribution to the probability of mean pulmonary arterial pressure > 20 mm Hg predicted by tricuspid regurgitation jet peak velocity solely. The impact of the novel mean pulmonary arterial pressure threshold on the echocardiographic prediction of pulmonary hypertension remains to be clarified by future studies.

Keywords: Echocardiography, pulmonary arterial pressure, pulmonary hypertension, redefinition, tricuspid regurgitation

Seda Tanyeri, Hacer Ceren Tokgöz, Ali Karagöz, Özgür Yasar Akbal, Berhan Keskin, Barkın Kültürsay, Aykun Hakgör, Şeyhmus Külahçıoglu, Doğancan Çeneli, Ayhan Tosun, Süleyman Efe, Zübeyde Bayram, Ibrahim Halil Tanboga, Nihal Özdemir, Cihangir Kaymaz. Reappraisal of the Transthoracic Echocardiographic Algorithm in Predicting Pulmonary Hypertension Redefined by Updated Pulmonary Artery Mean Pressure Threshold. Anatol J Cardiol. 2023; 27(6): 348-359

Corresponding Author: Cihangir Kaymaz
Manuscript Language: English


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