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Right Heart Catheterisation in Patients with Echocardiographic Diagnosis of Pulmonary Hypertension
Abstract
Background: Anaesthetists and other clinicians depend on echocardiographic estimation of pulmonary artery pressures for clinical decisions in cardiac patients. Our objective was to compare the systolic pulmonary arterial pressures estimated by echocardiography to that measured by right heart catheterisation.
Patients and Methods: This was a retrospective-prospective analytical study of all patients referred for right heart catheterisation (RHC) between 1st January 2006 and 31st March 2010. The echocardiographic (Echo) estimation of the systolic pulmonary artery pressures was compared to the systolic pulmonary artery pressures measured during right heart catheterisation.
Results: There were 64 patients, 37 (57.8%) were female, 27(42.2%) male. Twenty (31.3%) were between 11-20 years and 13 (20.3%) were 31-40 years. The youngest patient was 3 years old and the oldest 68 years. The Echo diagnosis was ASD, VSD, and Pulmonary Arterial Hypertension in 32.8%, 21.9% and 12.9% respectively. The right internal jugular vein was used in 58(90.6%) and the right femoral vein in 6(9.4%). Thirty-three (51.6%) had RHC systolic pressure greater than 35mmHg. Overall there was an inaccuracy of 69.8% for pressure measured by Echo. Echo was accurate in only 31.1% of instances in patients with congenital heart disease and inaccurate in all patients with rheumatic heart disease.
Conclusion: Differences exist between pressures measured by Echo and RHC. Clinically, these differences may to lead to inappropriate management of patients. RHC is therefore necessary in patients with significant pulmonary hypertension especially for congenital and rheumatic heart diseases.
Patients and Methods: This was a retrospective-prospective analytical study of all patients referred for right heart catheterisation (RHC) between 1st January 2006 and 31st March 2010. The echocardiographic (Echo) estimation of the systolic pulmonary artery pressures was compared to the systolic pulmonary artery pressures measured during right heart catheterisation.
Results: There were 64 patients, 37 (57.8%) were female, 27(42.2%) male. Twenty (31.3%) were between 11-20 years and 13 (20.3%) were 31-40 years. The youngest patient was 3 years old and the oldest 68 years. The Echo diagnosis was ASD, VSD, and Pulmonary Arterial Hypertension in 32.8%, 21.9% and 12.9% respectively. The right internal jugular vein was used in 58(90.6%) and the right femoral vein in 6(9.4%). Thirty-three (51.6%) had RHC systolic pressure greater than 35mmHg. Overall there was an inaccuracy of 69.8% for pressure measured by Echo. Echo was accurate in only 31.1% of instances in patients with congenital heart disease and inaccurate in all patients with rheumatic heart disease.
Conclusion: Differences exist between pressures measured by Echo and RHC. Clinically, these differences may to lead to inappropriate management of patients. RHC is therefore necessary in patients with significant pulmonary hypertension especially for congenital and rheumatic heart diseases.
