Published ahead of print on December 12, 2002, doi:10.1164/rccm.200210-1130OC
American Journal of Respiratory and Critical Care Medicine Vol 167. pp. 735-740, (2003)
© 2003 American Thoracic Society
Echocardiographic Assessment of Pulmonary Hypertension in Patients with Advanced Lung Disease
Selim M. Arcasoy,
Jason D. Christie,
Victor A. Ferrari,
Martin St. John Sutton,
David A. Zisman,
Nancy P. Blumenthal,
Alberto Pochettino and
Robert M. Kotloff
Division of Pulmonary, Allergy and Critical Care, Columbia University College of Physicians and Surgeons, New York, New York; and Divisions of Pulmonary, Allergy and Critical Care Medicine, Cardiothoracic Surgery, and Cardiovascular Medicine, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
Correspondence and requests for reprints should be addressed to Selim M. Arcasoy, M.D., Columbia University College of Physicians and Surgeons, Lung Transplantation Program, PH-14E, Room 104, 622 West 168th Street, New York, NY 10032. E-mail: sa2059{at}columbia.edu
Doppler echocardiography is commonly used to estimate systolic pulmonary artery pressure and to diagnose pulmonary hypertension, but data relating to its utility in patients with advanced lung disease are limited. In a cohort study of 374 lung transplant candidates, the performance characteristics of echocardiography compared with right heart catheterization in the determination of systolic pulmonary artery pressure and diagnosis of pulmonary hypertension were investigated. The prevalence of pulmonary hypertension was 25% in the study population. Estimation of systolic pulmonary artery pressure by echocardiography was possible in 166 patients (44%). The correlation between systolic pulmonary artery pressure estimated by echocardiography and measured by cardiac catheterization was good (r = 0.69, p < 0.0001). However, 52% of pressure estimations were found to be inaccurate (more than 10 mm Hg difference compared with measured pressure), and 48% of patients were misclassified as having pulmonary hypertension by echocardiography. Sensitivity, specificity, and positive and negative predictive values of systolic pulmonary artery pressure estimation for diagnosis of pulmonary hypertension were 85%, 55%, 52%, and 87%, respectively. In conclusion, despite a statistically significant correlation with directly measured values, estimation of systolic pulmonary artery pressure by echocardiography is frequently inaccurate in patients with advanced lung disease and leads to considerable overdiagnosis of pulmonary hypertension.
Key Words: pulmonary hypertension • echocardiography • cardiac catheterization • lung disease
This article has been cited by other articles:
|
|
|
|
 
A. Devaraj, A. U. Wells, M. G. Meister, T. J. Corte, and D. M. Hansell
The Effect of Diffuse Pulmonary Fibrosis on the Reliability of CT Signs of Pulmonary Hypertension
Radiology,
December 1, 2008;
249(3):
1042 - 1049.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Chaouat, R. Naeije, and E. Weitzenblum
Pulmonary hypertension in COPD
Eur. Respir. J.,
November 1, 2008;
32(5):
1371 - 1385.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. E. Furst
Outcome measures in rheumatologic clinical trials and systemic sclerosis
Rheumatology,
October 1, 2008;
47(suppl_5):
v29 - v30.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. M. Hoeper
Treating pulmonary hypertension in COPD: where do we start?
Eur. Respir. J.,
September 1, 2008;
32(3):
541 - 542.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A U Wells, N Hirani, and on behalf of the BTS Interstitial Lung Disease Gui
Interstitial lung disease guideline
Thorax,
September 1, 2008;
63(Suppl_5):
v1 - v58.
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. W. Farber
The Status of Pulmonary Arterial Hypertension in 2008
Circulation,
June 10, 2008;
117(23):
2966 - 2968.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Behr and J. H. Ryu
Pulmonary hypertension in interstitial lung disease
Eur. Respir. J.,
June 1, 2008;
31(6):
1357 - 1367.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. M. DeCamp Jr., D. Lipson, M. Krasna, O. A. Minai, R. J. McKenna Jr., and B. M. Thomashow
The Evaluation and Preparation of the Patient for Lung Volume Reduction Surgery
Proceedings of the ATS,
May 1, 2008;
5(4):
427 - 431.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. A. Falk, S. Kadiev, G. J. Criner, S. M. Scharf, O. A. Minai, and P. Diaz
Cardiac Disease in Chronic Obstructive Pulmonary Disease
Proceedings of the ATS,
May 1, 2008;
5(4):
543 - 548.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J Pope
An update in pulmonary hypertension in systemic lupus erythematosus - do we need to know about it?
Lupus,
April 1, 2008;
17(4):
274 - 277.
[Abstract]
[PDF]
|
|
|
|
|
|
|
H. Watz, B. Waschki, C. Boehme, M. Claussen, T. Meyer, and H. Magnussen
Extrapulmonary Effects of Chronic Obstructive Pulmonary Disease on Physical Activity: A Cross-sectional Study
Am. J. Respir. Crit. Care Med.,
April 1, 2008;
177(7):
743 - 751.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. A. Zisman, A. S. Karlamangla, S. M. Kawut, O. A. Shlobin, R. Saggar, D. J. Ross, M. I. Schwarz, J. A. Belperio, A. Ardehali, J. P. Lynch III, et al.
Validation of a Method To Screen for Pulmonary Hypertension in Advanced Idiopathic Pulmonary Fibrosis
Chest,
March 1, 2008;
133(3):
640 - 645.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. M. Mourani, M. K. Sontag, A. Younoszai, D. D. Ivy, and S. H. Abman
Clinical Utility of Echocardiography for the Diagnosis and Management of Pulmonary Vascular Disease in Young Children With Chronic Lung Disease
Pediatrics,
February 1, 2008;
121(2):
317 - 325.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. K. Han, V. V. McLaughlin, G. J. Criner, and F. J. Martinez
Pulmonary Diseases and the Heart
Circulation,
December 18, 2007;
116(25):
2992 - 3005.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. Venuta, S. Sciomer, C. Andreetti, M. Anile, T. De Giacomo, M. Rolla, F. Fedele, and G. F. Coloni
Long-term Doppler echocardiographic evaluation of the right heart after major lung resections
Eur. J. Cardiothorac. Surg.,
November 1, 2007;
32(5):
787 - 790.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. R. Fisher, G. J. Criner, A. P. Fishman, P. M. Hassoun, O. A. Minai, S. M. Scharf, a. H. E. Fessler, and for the National Emphysema Treatment Trial (NETT)
Estimating pulmonary artery pressures by echocardiography in patients with emphysema
Eur. Respir. J.,
November 1, 2007;
30(5):
914 - 921.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. M. Taveira-DaSilva, O. M. Hathaway, V. Sachdev, Y. Shizukuda, C. W. Birdsall, and J. Moss
Pulmonary Artery Pressure in Lymphangioleiomyomatosis: An Echocardiographic Study
Chest,
November 1, 2007;
132(5):
1573 - 1578.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. F. Shorr, J. L. Wainright, C. S. Cors, C. J. Lettieri, and S. D. Nathan
Pulmonary hypertension in patients with pulmonary fibrosis awaiting lung transplant
Eur. Respir. J.,
October 1, 2007;
30(4):
715 - 721.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
N. M. Patel, D. J. Lederer, A. C. Borczuk, and S. M. Kawut
Pulmonary Hypertension in Idiopathic Pulmonary Fibrosis
Chest,
September 1, 2007;
132(3):
998 - 1006.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. A. Zisman, A. S. Karlamangla, D. J. Ross, M. P. Keane, J. A. Belperio, R. Saggar, J. P. Lynch III, A. Ardehali, and J. Goldin
High-Resolution Chest CT Findings Do Not Predict the Presence of Pulmonary Hypertension in Advanced Idiopathic Pulmonary Fibrosis
Chest,
September 1, 2007;
132(3):
773 - 779.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
I. Noth and F. J. Martinez
Recent Advances in Idiopathic Pulmonary Fibrosis
Chest,
August 1, 2007;
132(2):
637 - 650.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. D. Nathan, P. W. Noble, and R. M. Tuder
Idiopathic Pulmonary Fibrosis and Pulmonary Hypertension: Connecting the Dots
Am. J. Respir. Crit. Care Med.,
May 1, 2007;
175(9):
875 - 880.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Dellegrottaglie, J. Sanz, M. Poon, J. F. Viles-Gonzalez, R. Sulica, M. Goyenechea, F. Macaluso, V. Fuster, and S. Rajagopalan
Pulmonary Hypertension: Accuracy of Detection with Left Ventricular Septal-to-Free Wall Curvature Ratio Measured at Cardiac MR
Radiology,
April 1, 2007;
243(1):
63 - 69.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. R. Collard, K. J. Anstrom, M. I. Schwarz, and D. A. Zisman
Sildenafil Improves Walk Distance in Idiopathic Pulmonary Fibrosis
Chest,
March 1, 2007;
131(3):
897 - 899.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Hamada, S. Nagai, S. Tanaka, T. Handa, M. Shigematsu, T. Nagao, M. Mishima, M. Kitaichi, and T. Izumi
Significance of Pulmonary Arterial Pressure and Diffusion Capacity of the Lung as Prognosticator in Patients With Idiopathic Pulmonary Fibrosis
Chest,
March 1, 2007;
131(3):
650 - 656.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. M. Hoeper, T. Welte, R. Tkacova, and P. Joppa
Systemic Inflammation, COPD, and Pulmonary Hypertension
Chest,
February 1, 2007;
131(2):
634 - 635.
[Full Text]
[PDF]
|
|
|
|
|
|
|
N. Collins, B. Bastian, L. Quiqueree, C. Jones, R. Morgan, and G. Reeves
Abnormal pulmonary vascular responses in patients registered with a systemic autoimmunity database: Pulmonary Hypertension Assessment and Screening Evaluation using stress echocardiography (PHASE-I)
Eur J Echocardiogr,
December 1, 2006;
7(6):
439 - 446.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. A. Fisher, D. M. Serlin, K. C. Wilson, R. E. Walter, J. S. Berman, and H. W. Farber
Sarcoidosis-Associated Pulmonary Hypertension: Outcome With Long-term Epoprostenol Treatment.
Chest,
November 1, 2006;
130(5):
1481 - 1488.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Joppa, D. Petrasova, B. Stancak, and R. Tkacova
Systemic Inflammation in Patients With COPD and Pulmonary Hypertension.
Chest,
August 1, 2006;
130(2):
326 - 333.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Handa, S. Nagai, S. Miki, Y. Fushimi, K. Ohta, M. Mishima, and T. Izumi
Incidence of Pulmonary Hypertension and Its Clinical Relevance in Patients With Sarcoidosis
Chest,
May 1, 2006;
129(5):
1246 - 1252.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. H. Leuchte, R. A. Baumgartner, M. E. Nounou, M. Vogeser, C. Neurohr, M. Trautnitz, and J. Behr
Brain Natriuretic Peptide Is a Prognostic Parameter in Chronic Lung Disease
Am. J. Respir. Crit. Care Med.,
April 1, 2006;
173(7):
744 - 750.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
I. Ben-Dor, M. R. Kramer, A. Raccah, Z. Iakobishvilli, D. Shitrit, G. Sahar, and D. Hasdai
Echocardiography Versus Right-Sided Heart Catheterization Among Lung Transplantation Candidates.
Ann. Thorac. Surg.,
March 1, 2006;
81(3):
1056 - 1060.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. J. Lettieri, S. D. Nathan, S. D. Barnett, S. Ahmad, and A. F. Shorr
Prevalence and Outcomes of Pulmonary Arterial Hypertension in Advanced Idiopathic Pulmonary Fibrosis
Chest,
March 1, 2006;
129(3):
746 - 752.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. F. Bruzzi, M. Remy-Jardin, D. Delhaye, A. Teisseire, C. Khalil, and J. Remy
When, Why, and How to Examine the Heart During Thoracic CT: Part 2, Clinical Applications
Am. J. Roentgenol.,
February 1, 2006;
186(2):
333 - 341.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. M. Toraldo, G. Nicolardi, F. De Nuccio, R. Lorenzo, and N. Ambrosino
Pattern of Variables Describing Desaturator COPD Patients, as Revealed by Cluster Analysis
Chest,
December 1, 2005;
128(6):
3828 - 3837.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. F. Nadrous, P. A. Pellikka, M. J. Krowka, K. L. Swanson, N. Chaowalit, P. A. Decker, and J. H. Ryu
Pulmonary Hypertension in Patients With Idiopathic Pulmonary Fibrosis
Chest,
October 1, 2005;
128(4):
2393 - 2399.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Sulica, A. S. Teirstein, S. Kakarla, N. Nemani, A. Behnegar, and M. L. Padilla
Distinctive Clinical, Radiographic, and Functional Characteristics of Patients With Sarcoidosis-Related Pulmonary Hypertension
Chest,
September 1, 2005;
128(3):
1483 - 1489.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Lindqvist, K. Caidahl, G. Neuman-Andersen, C. Ozolins, S. Rantapaa-Dahlqvist, A. Waldenstrom, and E. Kazzam
Disturbed Right Ventricular Diastolic Function in Patients With Systemic Sclerosis: A Doppler Tissue Imaging Study
Chest,
August 1, 2005;
128(2):
755 - 763.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. R. Fisher and P. M. Hassoun
Prediction of Pulmonary Artery Pressure
Chest,
July 1, 2005;
128(1):
466 - 467.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. F. Shorr, D. L. Helman, D. B. Davies, and S. D. Nathan
Pulmonary hypertension in advanced sarcoidosis: epidemiology and clinical characteristics
Eur. Respir. J.,
May 1, 2005;
25(5):
783 - 788.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Naeije
Pulmonary Hypertension and Right Heart Failure in Chronic Obstructive Pulmonary Disease
Proceedings of the ATS,
April 1, 2005;
2(1):
20 - 22.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. J. Roeleveld, J. T. Marcus, T. J. C. Faes, T.-J. Gan, A. Boonstra, P. E. Postmus, and A. Vonk-Noordegraaf
Interventricular Septal Configuration at MR Imaging and Pulmonary Arterial Pressure in Pulmonary Hypertension
Radiology,
March 1, 2005;
234(3):
710 - 717.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Bonay, C. Bancal, D. de Zuttere, F. Arnoult, G. Saumon, and F. Camus
Normal Pulmonary Capillary Blood Volume in Patients With Chronic Infiltrative Lung Disease and High Pulmonary Artery Pressure
Chest,
November 1, 2004;
126(5):
1460 - 1466.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
N. S. Hill
Brain Natriuretic Peptide: Is It Helpful in Detecting Pulmonary Hypertension in Fibrotic Lung Disease?
Am. J. Respir. Crit. Care Med.,
August 15, 2004;
170(4):
352 - 353.
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. H. Leuchte, C. Neurohr, R. Baumgartner, M. Holzapfel, W. Giehrl, M. Vogeser, and J. Behr
Brain Natriuretic Peptide and Exercise Capacity in Lung Fibrosis and Pulmonary Hypertension
Am. J. Respir. Crit. Care Med.,
August 15, 2004;
170(4):
360 - 365.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. J. Tobin
Chronic Obstructive Pulmonary Disease, Pollution, Pulmonary Vascular Disease, Transplantation, Pleural Disease, and Lung Cancer in AJRCCM 2003
Am. J. Respir. Crit. Care Med.,
January 15, 2004;
169(2):
301 - 313.
[Full Text]
[PDF]
|
|
|
|
|
|
|
V. N. Lama, K. R. Flaherty, G. B. Toews, T. V. Colby, W. D. Travis, Q. Long, S. Murray, E. A. Kazerooni, B. H. Gross, J. P. Lynch III, et al.
Prognostic Value of Desaturation during a 6-Minute Walk Test in Idiopathic Interstitial Pneumonia
Am. J. Respir. Crit. Care Med.,
November 1, 2003;
168(9):
1084 - 1090.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
What's the Significance of Echocardiographically Diagnosed Pulmonary Hypertension?
Journal Watch (General),
April 8, 2003;
2003(408):
4 - 4.
[Full Text]
|
|
|
Copyright © 2003 American Thoracic Society
|
|
|
