Echocardiographic prediction of pre- versus postcapillary pulmonary hypertension.

摘要: Background The differential diagnosis between pre- and postcapillary pulmonary hypertension (PH) is of major therapeutic relevance thus requires optimal clinical probability assessment with echocardiography. Methods We prospectively analyzed 152 consecutive patients referred to a PH center over 1-year period undergoing quasi-simultaneous (within 1 hour) echocardiography right heart catheterization. Echocardiography was performed as usually recommended for the left conditions. defined mean artery pressure ≥ 25 mm Hg. Postcapillary diagnosed on basis capillary wedge >15 mm Results Ten (7%) had no PH, 81 (53%) precapillary 61 (40%) PH. following five echocardiographic variables were found predict PH: chamber larger than ( P  = .0018), ventricular eccentricity index > 1.2  = .0039), dilated inferior vena cava without inspiratory collapse  = .0076), E/e′ ratio ≤10  = .00001), ventricle forming apex  = .0144). Beta coefficients from multiple logistic regression significant  = .0464) ≤ 10  = .0002). score based β coefficients, ranging 3 34 points, resulted in discrimination at >5, positive predictive value 67.9% negative 77.5% Conclusion enables clinically satisfactory