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Measurement of pulmonary arterial elastance in patients with systolic heart failure using Doppler echocardiography [Anatol J Cardiol]
Anatol J Cardiol. 2016; 16(3): 183-188 | DOI: 10.5152/akd.2015.5980  

Measurement of pulmonary arterial elastance in patients with systolic heart failure using Doppler echocardiography

Sepideh Taghavi1, Maryam Esmaeilzadeh2, Ahmad Amin1, Nasim Naderi1, Hooman Bakhshandeh Abkenar3, Majid Maleki2, Mitra Chitsazan3
1Departments of Heart Failure and Transplantation, ran University of Medical Science; Tehran- Iran
2Echocardiography Research Center, Iran University of Medical Science; Tehran- Iran
3Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Science; Tehran- Iran

Objective: A reliable and easy-to-perform method for measuring right ventricular (RV) afterload is desirable when scheduling patients with systolic heart failure to undergo heart transplantation. The present study aimed to investigate the accuracy of echocardiographically-derived pulmonary arterial elastance as a measurement of pulmonary vascular resistance by comparing it with invasive measures.
Methods: Thirty-one patients with moderate to severe systolic heart failure, including 22 (71%) male patients, with a mean age of 41.1615.9 years were enrolled in the study. Right heart catheterization and comprehensive echocardiography during the first hour after completion of cardiac catheterization were performed in all the patients. The pulmonary artery elastance was estimated using the ratio of end-systolic pressure (Pes) over the stroke volume (SV) by both cardiac catheterization [Ea (PV)-C] and echocardiography [Ea (PV)-E].
Results: The mean Ea (PV)-C and Ea (PV)-E were estimated to be 0.730.49 mm Hg/mL and 0.670.44 mm Hg/mL, respectively. There was a significant relation between Ea (PV)-E and Ea (PV)-C (r=0.897, p<0.001). Agreement between echocardiography and catheterization methods for estimating Ea (PV), investigated by the Bland-Altman method, showed a mean bias of -0.06, with 95% limits of agreement from -0.36 mm Hg/mL to 0.48 mm Hg/mL.
Conclusion: Doppler echocardiography is an easy, non-invasive, and inexpensive method for measuring pulmonary arterial elastance, which provides accurate and reliable estimation of RV afterload in patients with systolic heart failure. (Anatol J Cardiol 2016; 16: 183-8)

Keywords: arterial elastance, Doppler echocardiography, pulmonary artery, right ventricular function


Sepideh Taghavi, Maryam Esmaeilzadeh, Ahmad Amin, Nasim Naderi, Hooman Bakhshandeh Abkenar, Majid Maleki, Mitra Chitsazan. Measurement of pulmonary arterial elastance in patients with systolic heart failure using Doppler echocardiography. Anatol J Cardiol. 2016; 16(3): 183-188

Corresponding Author: Maryam Esmaeilzadeh, Iran


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