The relationship between pulmonary artery wedge pressure and pulmonary blood volume derived from contrast echocardiography

A proof-of-concept study

Ken Monahan, Daniel Lenihan, Evan L. Brittain, Linda Saliba, Robert N. Piana, Leslie L. Robison, Melissa M. Hudson, Gregory Armstrong

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Pulmonary transit time (PTT) obtained from contrast echocardiography is a marker of global cardiopulmonary function. Pulmonary blood volume (PBV), derived from PTT, may be a noninvasive surrogate for left-sided filling pressures, such as pulmonary artery wedge pressure (PAWP). We sought to assess the relationship between PBV obtained from contrast echocardiography and PAWP. Methods: Participants were adult survivors of childhood cancer that had contrast echocardiography performed nearly simultaneously with right-heart catheterization. PTT was derived from time-intensity curves of contrast passage through the right ventricle (RV) and left atrium (LA). PBV relative to overall stroke volume (rPBV) was estimated from the product of PTT and heart rate during RV-LA transit. PAWP was obtained during standard right-heart catheterization. The Spearman correlation coefficient was used to assess the relationship between rPBV and PAWP. Results: The study population consisted of 7 individuals who had contrast echocardiography and right-heart catheterization within 3 hours of each other. There was a wide range of right atrial (1–17 mm Hg), mean pulmonary artery (18–42 mm Hg), and PAW pressures (4–26 mm Hg) as well as pulmonary vascular resistance (<1–6 Wood Units). We observed a statistically significant correlation between rPBV and PAWP (r =.85; P =.02). Conclusion: Relative PBV derived from contrast echocardiography correlates with PAWP. If validated in larger studies, rPBV could potentially be used as an alternative to invasively determine left-sided filling pressure.

Original languageEnglish (US)
Pages (from-to)1266-1270
Number of pages5
JournalEchocardiography
Volume35
Issue number9
DOIs
StatePublished - Sep 1 2018

Fingerprint

Pulmonary Wedge Pressure
Blood Volume
Echocardiography
Lung
Cardiac Catheterization
Heart Atria
Pressure
Heart Ventricles
Vascular Resistance
Stroke Volume
Pulmonary Artery
Heart Rate

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

The relationship between pulmonary artery wedge pressure and pulmonary blood volume derived from contrast echocardiography : A proof-of-concept study. / Monahan, Ken; Lenihan, Daniel; Brittain, Evan L.; Saliba, Linda; Piana, Robert N.; Robison, Leslie L.; Hudson, Melissa M.; Armstrong, Gregory.

In: Echocardiography, Vol. 35, No. 9, 01.09.2018, p. 1266-1270.

Research output: Contribution to journalArticle

Monahan, Ken ; Lenihan, Daniel ; Brittain, Evan L. ; Saliba, Linda ; Piana, Robert N. ; Robison, Leslie L. ; Hudson, Melissa M. ; Armstrong, Gregory. / The relationship between pulmonary artery wedge pressure and pulmonary blood volume derived from contrast echocardiography : A proof-of-concept study. In: Echocardiography. 2018 ; Vol. 35, No. 9. pp. 1266-1270.
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AB - Background: Pulmonary transit time (PTT) obtained from contrast echocardiography is a marker of global cardiopulmonary function. Pulmonary blood volume (PBV), derived from PTT, may be a noninvasive surrogate for left-sided filling pressures, such as pulmonary artery wedge pressure (PAWP). We sought to assess the relationship between PBV obtained from contrast echocardiography and PAWP. Methods: Participants were adult survivors of childhood cancer that had contrast echocardiography performed nearly simultaneously with right-heart catheterization. PTT was derived from time-intensity curves of contrast passage through the right ventricle (RV) and left atrium (LA). PBV relative to overall stroke volume (rPBV) was estimated from the product of PTT and heart rate during RV-LA transit. PAWP was obtained during standard right-heart catheterization. The Spearman correlation coefficient was used to assess the relationship between rPBV and PAWP. Results: The study population consisted of 7 individuals who had contrast echocardiography and right-heart catheterization within 3 hours of each other. There was a wide range of right atrial (1–17 mm Hg), mean pulmonary artery (18–42 mm Hg), and PAW pressures (4–26 mm Hg) as well as pulmonary vascular resistance (<1–6 Wood Units). We observed a statistically significant correlation between rPBV and PAWP (r =.85; P =.02). Conclusion: Relative PBV derived from contrast echocardiography correlates with PAWP. If validated in larger studies, rPBV could potentially be used as an alternative to invasively determine left-sided filling pressure.

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