Doppler echocardiography pulmonary artery flow acceleration time: an adjunctive parameter to select candidates with suspected pulmonary hypertension to proceed to right heart catheterization

Abstract

P331 Doppler echocardiography pulmonary artery flow acceleration time: an adjunctive parameter to select candidates with suspected pulmonary hypertension to proceed to right heart catheterization Background: Pulmonary hypertension (PH) is associated with a worsening prognosis especially if specific treatment is delayed. The gold standard technique for diagnosis of PH is right heart catheterization (RHC), an invasive procedure associated with several complications. European Society of Cardiology (ESC) Guidelines for the management of PH identify the echocardiographic estimation of systolic pulmonary arterial pressure (sPAP) from tricuspid regurgitation velocity (TRV) as the method of choice for selecting patients (pt) eligible for RHC. However, several studies indicate that echocardiographic TRV and sPAP estimation have high specificity for PH diagnosis only when moderately elevated (TRV>3.4 m/sec, sPAP>50 mmHg). Indeed, for TRV>2.9 m/sec but <3.4 m/sec, many false positive pt undergo unnecessary RHC. The measurement of the acceleration time (Act) of pulmonary artery flow has been increasingly used as an index of increased right ventricular pressure and thus of PH. Our aim was to test the efficacy of Act as an additional screening parameter for the selection of pt eligible for RHC.