Abstract
PAAT/RVET PULMONARY ARTERY ACCELERATION TIME IN DIAGNOSIS OF PULMONARY HYPERTENSION BY PULSED WAVE SPECTRAL DOPPLER TECHNIQUE

Dr. Ghazi Farhan, Dr. Wajih Qasim Taha and Imad Mahmood Hussein

ABSTRACT

Pulmonary hypertension is a pathophysiological, hemodynamic condition defined as an increase in mean pulmonary arterial pressure ≥ 25 mmHg at rest, assessed by right heart catheterization which is the gold standard investigation despite its own inherent risks. Transthoracic echocardiographic estimates pulmonary artery pressure conventionally calculated from the maximal velocity of the tricuspid regurgitation jet (traditional method). Pulmonary artery acceleration time is an accurate parameter reflecting pulmonary artery Systolic pressure independently of tricuspid regurgitation. This study aimed to assess echocardiographic pulmonary artery acceleration time in the diagnosis of PHT when compared with TR jet using pulsed wave doppler spectral technique in suspected patients with pulmonary hypertension. This is a multicenter cross-sectional study performed in Baghdad/ Iraq from June 2017 to May 2018 on 245 referred patients with unexplained shortness of breathing. Each patient was subjected to transthoracic echocardiogram using Pulsed-wave Doppler measuring pulmonary artery acceleration time, while the Continuous-wave Doppler was used to measure the peak velocity of TR, in addition to find the correlation between that Pulmonary Artery Acceleration Time and Pulmonary Artery Systolic Pressure. The patients were divided into 2 groups; 183 With no PHT & 62 with PHT. There was a significant correlation between Pulmonary Artery Systolic Pressure and Peak velocity of TR, Pulmonary Artery Systolic Pressure and Pulmonary Artery Acceleration Time /RV Ejection Time. Pulmonary Artery Acceleration Time was an excellent prediction of PHT, with (93.6% sensitivity), (95.1% specificity), it can be concluded that pulmonary artery acceleration time is a useful, valuable, easily obtainable and accurate Echo parameter when compared with Peak velocity of TR in the assessment of Pulmonary Artery Systolic.

Keywords: Pulmonary artery acceleration time, Pulmonary hypertension, Pulsed wave spectral doppler technique.


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