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Vol. 43. Issue 5.
Pages 267-271 (January 2007)
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Vol. 43. Issue 5.
Pages 267-271 (January 2007)
Original Articles
DOI: 10.1016/S1579-2129(07)60065-2
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Noninvasive, Indirect Measurement of Pulmonary Artery Pressure
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Isabel Blanco Vicha,
Corresponding author
isabeldoctora@yahoo.es

Correspondence: Dra. I. Blanco Vich. Departamento de Neumología. Hospital de la Santa Creu i Sant Pau. Sant Antoni M. Claret, 167. 08025 Barcelona. España
, José Belda Ramírezb, Pere Casan Claràa
a Departamento de Neumología. Hospital de la Santa Creu i Sant Pau. Facultad de Medicina, Universidad Autónoma de Barcelona, Barcelona, Spain
b Servicio de Neumología, Hospital General, Valencia, Spain
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Objective

The gold standard for measuring pulmonary artery pressure (PAP) is right heart catheterization. However, the usefulness of this technique is limited in patients with lung disease because of a poor acoustic window. The aim of this study was to assess PAP in a group of healthy persons using a noninvasive, indirect measurement procedure derived from the venous return flow velocity wave.

Material and methods

Twenty-three healthy volunteers with a mean (SD) age of 34 (9) years were evaluated. Measurements were made with a Hitachi EUB 5000 ultrasound device (3.5 MHz wave). The subject was placed in supine decubitus with neck hyperextended and head turned to one side. B-mode images were used to locate the point in the internal jugular vein 1 cm higher than its union with the subclavian vein. A color flow image was obtained of the vessel and a pulsed wave was then used to measure velocities. After 5 identical cycles, an estimate of PAP was derived from the ratio of maximum diastolic and systolic flow rates.

Results

On the right side, the mean (SD) ratio between flow rates was 0.50 (0.08), corresponding to a mean PAP of 15 (2.4) mm Hg. On the left side, the ratio was 0.55 (0.09), corresponding to a mean PAP of 16 (2.8) mm Hg. The nonsignificant difference between mean PAP values on the right and left was 1.3 (3.1) mm Hg, and higher values were on the left.

Conclusions

Mean PAP values obtained with the described procedure are within the normal range for a healthy population. Transcutaneous venous Doppler ultrasound is useful for estimating PAP in healthy individuals

Key words:
Pulmonary arterial pressure
Transcutaneous Doppler ultrasound
Reference values
Objetivo

El procedimiento de referencia para determi-nar la presión arterial pulmonar (PAP) es el cateterismo de-recho. Clínicamente se usa la ecocardiografía, que presenta limitaciones en pacientes con neumopatía, por mala ventana ecográfica. El objetivo del presente estudio ha sido determi-nar la PAP en un grupo de personas sanas mediante un pro-cedimiento indirecto e incruento que se basa en la curva de velocidad del retorno venoso.

Material y métodos

Se evaluó a 23 voluntarios sanos, con una edad media ± desviación estándar de 34 ± 9 años. Las medidas se realizaron con un ecógrafo Hitachi EUB 5000 (sonda de 3,5 MHz). El procedimiento consiste en si-tuar al sujeto en decúbito supino con el cuello hiperextendi-do y lateralizado. Se localiza en modo B la vena yugular in-terna 1 cm por encima de la unión con la subclavia. Con la Doppler color se sigue dicho trayecto y con la Doppler de onda pulsada se obtienen las curvas de velocidades. Tras 5 ciclos idénticos se procede a estimar la PAP a través de la relación de velocidades máximas diastólica y sistólica.

Resultados

En el lado derecho, el valor medio de la rela-ción de velocidades fue de 0,50 ± 0,08, que equivale a una PAP media de 15 ± 2,4 mmHg. En el lado izquierdo la rela-ción de velocidades fue de 0,55 ± 0,09, con una PAP media de 16 ± 2,8 mmHg. La diferencia entre las PAP medias dere-cha e izquierda fue de 1,3 ± 3,1 mmHg, y los valores, más elevados en el lado izquierdo (p no significativo).

Conclusiones

Los valores medios de PAP obtenidos con el procedimiento descrito están en el margen de referencia para la población sana. La ecografía Doppler venosa y transcutánea es un procedimiento útil para obtener los valo-res de PAP en personas sanas.

Palabras clave:
Presión arterial pulmonar
Ecografía Doppler transcutánea
Valores de referencia
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This study was partly funded by the Breathe Network (Red Respira) of the Instituto de Salud Carlos III and the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR).

Copyright © 2007. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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