Invasive hemodynamic procedures are still necessary to appreciate pulmonary hypertension characteristics. A few studies have adressed the issue of echocardiographic evaluation, but lack an external validation of their results with various settings and patients. The aim of our study was to appreciate the value of 2 published echocardiographic evaluations of pulmonary vascular resistances (PVR) based on tricuspid regurgitation maximal velocity (TRV) and right ventricular outflow tract systolic time velocity integral (TVI).

All of the patients presenting during 2013 for invasive haemo-dynamic evaluation with a suspected pulmonary hypertension were prospec-tively included, with echocardiography being done within 24 hours of catheterization. The TRV/TVI and TRV²/TVI ratio and echographic estimations of PVR were compared with catheter values; predictive values to detect elevated PVR were assessed.

43 patients were included, 12 with atrial fibrillation, 16 with valvular disease, 14 with hypertrophic cardiopathy. Mean pulmonary pressure was 41±11mmHg. TRV/TVI and TRV²/TVI were correlated with PVR (r=0.71 and r=0.78 respectively, p<0.01). Using TRV²/TVI, a cutpoint value of 0.98 had a specificity of 86% and a sensitiviy of 80% to predict PVR over 6 UW. Estimation of PVR with the previously published formula PVR = 5,19 TRV²/TVI - 0.4 was 100% correct to predict an PVR under 3 UW and 93% correct to predict an PVR over 6 UW.

Our results confirm the value of echocardiographic measurement of TRV²/TVI to evaluate PVR in a routine fashion for a non-selected population with high pulmonary pressure (figure next page).