Resistência pulmonar não invasiva ao Eco.

Echocardiography based estimation of pulmonary vascular resistance in patients with pulmonary hypertension: a simultaneous Doppler echocardiography and cardiac catheterization study
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Methods and results We investigated 30 patients undergoing right heart catheterization (RHC), mean age 62 ± 13 years, 21 females, with different diseases; idiopathic pulmonary arterial hypertension (PAH) (n= 5), associated PAH (n= 16), chronic thromboembolic PH (n= 6), interstitial lung disease (n= 2), and after closure of an atrial septal defect (n= 1). Patients with impaired left ventricular systolic function (EF < 50%) or elevated pulmonary capillary wedge pressure (PCWP >15 mmHg on RHC) were excluded. We used the formula: PAMP = PASPecho × 0.61 + 2 mmHg, where PASPecho is the peak tricuspid regurgitation pressure drop + 10 or 7 mmHg. Pulmonary vascular resistance was then calculated as PAMPecho− PCWP/cardiac output. Pulmonary capillary wedge pressure was estimated at 10 mmHg in all cases. The Doppler-derived estimation of PVRecho was achievable in 90% of patients, in whom accurate calculation of PAMP was obtainable. Pulmonary vascular resistance echo individual values strongly correlated with those from RHC (r= 0.85, P< 0.001 and r= 0.87, P< 0.001 for the two estimated values for right atrial pressure, respectively). The regression equation using this formula was PVRrhc = 0.95 × PVRecho− 0.29, and the regression line was close to identity. The Bland–Altman plot showed a good agreement between PVRecho and PVRrhc values, with a mean difference of −0.66 ± 2.1 Wood unit. . Fórmulas: PAMP = PASPecho × 0.61 + 2 mmHg, where PASPecho is the peak tricuspid regurgitation pressure drop + 10 or 7 mmHg.
Resist= PAMPecho− PCWP/cardiac output
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Artigo demonstra forte correlação entre a resistência pulmonar calculada e a medida.
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Porém, só em pacientes sem aumento da pressão atrial esquerda!!!!
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