Abstract
I read with great interest the study by Bouchard et al, 1 Bouchard J.L. Aurigemma G.P. Hill J.C. Ennis C.A. Tighe D.A. Usefulness of the pulmonary arterial systolic pressure to predict pulmonary arterial wedge pressure in patients with normal left ventricular systolic function. Am J Cardiol. 2008; 101: 1673-1676 Abstract Full Text Full Text PDF PubMed Scopus (32) Google Scholar who addressed the usefulness of pulmonary arterial systolic pressure in noninvasively predicting pulmonary capillary pressure. In their clever clinical study, the investigators proposed indirectly assessing left ventricular filling pressures from measures of peak tricuspid regurgitant velocity and cardiac output, assuming clinically that pulmonary vascular resistance is within the normal range. This method is appealing because pulmonary arterial systolic pressure and cardiac output are easily obtained in most patients, with potential clinical applications in patients with suspected heart failure and normal ejection fractions. Accordingly, it appears of clinical importance to emphasize that pulmonary vascular resistance is currently measurable in a simple and reliable manner, by calculating the ratio of peak tricuspid regurgitant velocity to the right ventricular outflow tract time-velocity integral. 2 Abbas A.E. Fortuin F.D. Schiller N.B. Appleton C.P. Moreno C.A. Lester S.J. A simple method for noninvasive estimation of pulmonary vascular resistance. J Am Coll Cardiol. 2003; 41: 1021-1027 Abstract Full Text Full Text PDF PubMed Scopus (462) Google Scholar Because the clinical relevance of such a noninvasive surrogate of pulmonary vascular resistance has been reported in multiple clinical settings, 2 Abbas A.E. Fortuin F.D. Schiller N.B. Appleton C.P. Moreno C.A. Lester S.J. A simple method for noninvasive estimation of pulmonary vascular resistance. J Am Coll Cardiol. 2003; 41: 1021-1027 Abstract Full Text Full Text PDF PubMed Scopus (462) Google Scholar , 3 Bidart C.M. Abbas A.E. Parish J.M. Chaliki H.P. Moreno C.A. Lester S.J. The noninvasive evaluation of exercise-induced changes in pulmonary artery pressure and pulmonary vascular resistance. J Am Soc Echocardiogr. 2007; 20: 270-275 Abstract Full Text Full Text PDF PubMed Scopus (59) Google Scholar , 4 Farzaneh-Far R. McKeown B.H. Dang D. Roberts J. Schiller N.B. Foster E. Accuracy of Doppler-estimated pulmonary vascular resistance in patients before liver transplantation. Am J Cardiol. 2008; 101: 259-262 Abstract Full Text Full Text PDF PubMed Scopus (47) Google Scholar , 5 Vlahos AP, Feinstein JA, Schiller NB, Silverman NH. Extension of Doppler-derived echocardiographic measures of pulmonary vascular resistance to patients with moderate or severe pulmonary vascular disease. J Am Soc Echocardiogr. In press. Google Scholar it is likely to become a useful prerequisite to the Doppler method proposed by Bouchard et al. 1 Bouchard J.L. Aurigemma G.P. Hill J.C. Ennis C.A. Tighe D.A. Usefulness of the pulmonary arterial systolic pressure to predict pulmonary arterial wedge pressure in patients with normal left ventricular systolic function. Am J Cardiol. 2008; 101: 1673-1676 Abstract Full Text Full Text PDF PubMed Scopus (32) Google Scholar
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