loading page

Pulmonary arterial systolic pressure / Acceleration Time of Pulmonary outflow relationship to evaluate the pulmonary ventricle interaction
  • Walter SerraOrcid,
  • Alfredo Chetta
Walter Serra
Orcid
University Hospital of Parma
Author Profile
Alfredo Chetta
University Hospital of Parma
Author Profile

Abstract

Background: In pulmonary hypertension (PH), the development of dilatation and the right ventricular failure are signs of accelerated progression of the disease, resulting in an increased risk of cardiac death and right ventricular failure. Even the non-invasive assessment of the systolic blood pressure in the pulmonary artery by echocardiography does not provide a measure of ventricle-pulmonary interaction. Some studies showed that the potential use of echocardiography to evaluate indirectly the pulmonary vascular resistance (PVR) and the acceleration time of pulmonary outflow (ACTPO) could be a good, correlated, indirect measure. Methods: We decided to use a parameter that contained information related to pulmonary artery pressure (sPAP) and pulmonary vascular resistance. We called it PAPs/ACTPO ratio [strength/surface unit]/[time]. We aimed to study this parameter in apparently healthy subjects to code the normal range. From January 2017 to December 2018, 60 normal volunteer subjects and 63 patients with systemic scleroderma (Ssc)(60F,3M), 27 with PH and 36 without PH at two-dimensional echocardiographic/Doppler evaluation. Results: In normal subjects, we found a mean sPAP/ACTPO ratio of 0.26 indicative of an optimal pulmonary arterial ventricle coupling and biventricular function. The data derived from the analysis of the patients with Ssc showed that those presenting pre-capillary PH at cardiac catheterization had a sPAP/ACTPO ratio of 0.40 ± 0.05. There was a significant correlation between sPAP/ACTPO with Walk Distance (WD) and PVR but not with TAPSE. Interobserver variability was lower than 5%.