Mais do Eco sobre a resistência pulmonar.

Echocardiography can Identify Patients with Increased Pulmonary Vascular Resistance by Assessing Pressure Reflection in the Pulmonary Circulation
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Methods and Results—The study comprised 98 patients investigated within 24 hours of right heart catheterization and 20 control subjects. The pressure reflection variables were obtained using pulsed Doppler in the pulmonary artery and continuous Doppler of the tricuspid regurgitation. We selected three variables related to pressure reflection: the interval from valve opening to peak velocity in the pulmonary artery (AcT, ms), the interval between pulmonary artery peak velocity and peak tricuspid velocity (tPV-PP, ms) and the right ventricular pressure increase after peak velocity in the pulmonary artery (augmented pressure, AP, mmHg). The correlation between simultaneous catheter- and echocardiography-determined AP was strong (n=19, R=0.83). The AcT/tPV-PP/AP in patients with a PVR of > 3 WU (n=71) was (mean±SD) 77 ± 16/119 ± 36/22 ± 12 and differed from patients with a PVR of 3 WU (n=27, p<0.0001) 111 ± 32/39 ± 54/3 ± 4 and controls 153 ± 32/-19 ± 45/0 (p<0.0001). The AcT/tPV-PP/AP did not correlate with capillary wedge pressure (R 0.08-0.16). The areas under the receiver operator characteristic curve (95% CI) for AcT/tPV-PP/AP were 0.87 (0.82-0.95)/0.94 (0.89-0.99)/0.98 (0.95-1.0).
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Nova forma de estimar a resistência pulmonar, sendo necessário usar o ECG e fazer várias medidas finas.
Mesmo assim, vale a pena pela alta correlação(0,83).
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Para uso restrito mas confiável.
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Na rotina, ficamos com o tempo de aceleração do fluxo pulmonar e refluxo tricúspide.
Com sorte, obtemos também a velocidade final do refluxo pulmonar para a estimativa da diastólica pulmonar.
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Nenhum laudo pode sair sem uma estimativa da pressão pulmonar.
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