VALUE OF DOPPLER-ECHOCARDIOGRAPHY IN THE ASSESSMENT OF CHRONIC RIGHT-VENTRICULAR PRESSURE LOAD

Doppler-echocardiography (DEC) was performed before cardiac catheteriz ation in 61 consecutive patients (25 women, 36 men; aged 59 +/- 10.6 y ears) with pulmonary hypertension. Chronic obstructive lung disease wa s its cause in 32, mitral valve disease in 16 and dilated cardiomyopat hy in 13 patients. The subcostal approach was possible in all patients and a semiquantitative assessment into three degrees of severity dete rmined from right ventricular wall thickness and size, as well as the diameter of the inferior vena cava. The severity grade was closely cor related with the level of pulmonary hypertension. In the absence of al l signs of increased right ventricular load (grade 0) the mean pulmona ry arterial pressure was 18.7 +/- 6.2 mm Hg, in grade I it was 15 and 22 mm Hg (only two patients), in grade II 29.9 +/- 11.9 and in grade I II 41.1 +/- 8.6 mm Hg. 1 3 of the 21 patients in grade 0 or I had no m anifest signs of pulmonary hypertension, but this was the case in only 6 of 22 in grade II and none in grade III. In 42 patients (69%) the s ystolic pulmonary artery pressure could be measured by DEC and it corr elated well with the values obtained by cardiac catheterization (P < 0 .001, r = 0.92). - These findings show that DEC can provide semiquanti tative and, in most cases, even exact evidence of chronic right ventri cular overload.