P794Applcation of 3D echocardiography in pulmonary hypertensive patients: which indices associate with right heart catheterization?

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Purpose: The establishment of non-invasive parameters which will accurately reflect resistance and impairment are mandatory for temporary clinical practice. The aim of this study is to investigate the relationship between right heart catheterization and 3D echocardiography.Methods: 112 patients with pulmonary arterial hypertension (mean age 43.2 ± 14.2 years). The gold standard exam was right heart catheterization (pulmonary capillary wedge pressure < 15 mmHg and pulmonary vascular resistance > 3 Wood). All patients had RHc and 3DE within the same week. The following parameters were measured : mean systolic pressure of the pulmonary artery (PASPcath), pulmonary capillary wedge pressure (PCWP), pulmonary vascular resistance (PVR) for RHc and end-diastolic, end-systolic volumes (EDV-ESV), right ventricular ejection fraction (EF), right ventricular mass (RVmass), and right ventricular sphericity index (SI).Results: The mean values were as following : RHc : mean PASPcath 98 ± 18 mmHg, mean PCWP 11.4 ± 1.6 mmHg, PVR 12.6 ± 5.7 Wood. 3DE : mean EDV 158 ± 43 ml, ESV 92 ± 26 ml, EF 34.6 ± 15.2%, RM 77.9 ± 18 g, sphericity index 19 ± 2.8. Strong agreement PASPcath and EF (r = 0.86, p =0.02), PVR and EDV (r = 0.74, p=0.01). Poor agreement between PASPcath-RM (r=0.16, p=0.72) and PASPcath-SI (r =0.28, p=0.67).Conlusions: Volumes and ejection fraction are definitive for pulmonary hypertension progress. Less reliable are RV mass and sphericity index, probably due to the complex geometry of right ventricular remodeling.

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