Echocardiographic assessment of pulmonary hypertension: a guideline protocol from
the British Society of Echocardiography
#MMPMID30012832
Augustine DX
; Coates-Bradshaw LD
; Willis J
; Harkness A
; Ring L
; Grapsa J
; Coghlan G
; Kaye N
; Oxborough D
; Robinson S
; Sandoval J
; Rana BS
; Siva A
; Nihoyannopoulos P
; Howard LS
; Fox K
; Bhattacharyya S
; Sharma V
; Steeds RP
; Mathew T
Echo Res Pract
2018[Sep]; 5
(3
): G11-G24
PMID30012832
show ga
Pulmonary hypertension is defined as a mean arterial pressure of ?25?mmHg as
confirmed on right heart catheterisation. Traditionally, the pulmonary arterial
systolic pressure has been estimated on echo by utilising the simplified
Bernoulli equation from the peak tricuspid regurgitant velocity and adding this
to an estimate of right atrial pressure. Previous studies have demonstrated a
correlation between this estimate of pulmonary arterial systolic pressure and
that obtained from invasive measurement across a cohort of patients. However, for
an individual patient significant overestimation and underestimation can occur
and the levels of agreement between the two is poor. Recent guidance has
suggested that echocardiographic assessment of pulmonary hypertension should be
limited to determining the probability of pulmonary hypertension being present
rather than estimating the pulmonary artery pressure. In those patients in whom
the presence of pulmonary hypertension requires confirmation, this should be done
with right heart catheterisation when indicated. This guideline protocol from the
British Society of Echocardiography aims to outline a practical approach to
assessing the probability of pulmonary hypertension using echocardiography and
should be used in conjunction with the previously published minimum dataset for a
standard transthoracic echocardiogram.
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