Pulmonary Venous Flow Index as a Predictor of Pulmonary Vascular Resistance Variability in Congenital Heart Disease with Increased Pulmonary Flow: A Comparative Study before and after Oxygen Inhalation

Pulmonary Venous Flow Index as a Predictor of Pulmonary Vascular Resistance Variability in Congenital Heart Disease with Increased Pulmonary Flow: A Comparative Study before and after Oxygen Inhalation

Author Rivera, Ivan Romero Autor UNIFESP Google Scholar
Mendonca, Maria Alayde Autor UNIFESP Google Scholar
Andrade, Jose Lazaro Autor UNIFESP Google Scholar
Moises, Valdir Autor UNIFESP Google Scholar
Campos, Orlando Autor UNIFESP Google Scholar
Silva, Celia Camelo Autor UNIFESP Google Scholar
Carvalho, Antonio Carlos Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Aims: There is no definitive and reliable echocardiographic method for estimating the pulmonary vascular resistance (PVR) to differentiate persistent vascular disease from dynamic pulmonary hypertension. the aim of this study was to analyze the relationship between the pulmonary venous blood flow velocity- time integral (VTIpv) and PVR. Methods and Results: Eighteen patients (10 females; 4 months to 22 years of age) with congenital heart disease and left to right shunt were studied. They underwent complete cardiac catheterization, including measurements of the PVR and Qp: Qs ratio, before and after 100% oxygen inhalation. Simultaneous left inferior pulmonary venous flow VTIpv was obtained by Doppler echocardiography. the PVR decreased significantly from 5.0 +/- 2.6 W to 2.8 +/- 2.2 W (P = 0.0001) with a significant increase in the Qp: Qs ratio, from 3.2 +/- 1.4 to 4.9 +/- 2.4 (P = 0.0008), and the VTIpv increased significantly from 22.6 +/- 4.7 cm to 28.1 +/- 6.2 cm (P = 0.0002) after 100% oxygen inhalation. VTIpv correlated well with the PVR and Qp: Qs ratio (r = -0.74 and 0.72, respectively). Diagnostic indexes indicated a sensitivity of 86%, specificity of 75%, accuracy of 83%, a positive predictive value of 92% and a negative predictive value of 60%. Conclusion : the VTIpv correlated well with the PVR. the measurement of this index before and after oxygen inhalation may become a useful noninvasive test for differentiating persistent vascular disease from dynamic and flow-related pulmonary hypertension.
Keywords echocardiography
Doppler
congenital heart disease
pulmonary vein
pulmonary venous flow
pulmonary hypertension
Language English
Date 2013-09-01
Published in Echocardiography-a Journal of Cardiovascular Ultrasound and Allied Techniques. Hoboken: Wiley-Blackwell, v. 30, n. 8, p. 952-960, 2013.
ISSN 0742-2822 (Sherpa/Romeo, impact factor)
Publisher Wiley-Blackwell
Extent 952-960
Origin http://dx.doi.org/10.1111/echo.12163
Access rights Closed access
Type Article
Web of Science ID WOS:000324017700025
URI http://repositorio.unifesp.br/handle/11600/36731

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