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Noninvasive Estimation of Right-Sided Pressures From Spectral Doppler Recordings of Tricupsid and Pulmonic Regurgitant Velocities

Steven J. Lavine, MD (Wayne State University, Detroit, MI)
Author and Funding Information

Director, Noninvasive Laboratory, Harper Hospital, Wayne State University School of Medicine.

Correspondence to: Steven J. Lavine, MD, Director, Noninvasive Laboratory, Harper Hospital, 3990 John R, Detroit, MI 48201.



Chest. 1999;116(1):1-3. doi:10.1378/chest.116.1.1
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Extract

For over a decade in noninvasive laboratories around the world, analyses of tricuspid regurgitant velocities have been performed, with estimations of pulmonary artery systolic pressure being generated. These estimations have been important in assessing the presence of pulmonary hypertension, its progression over time, and its response to therapy. For at least 5 years, many noninvasive laboratories have recorded pulmonary artery regurgitant signals for the estimation of mean and diastolic pulmonary artery pressures. Mean pulmonic pressure has been estimated from the peak pulmonic regurgitant velocity, and the pulmonary artery diastolic pressure has been estimated from the end-diastolic pulmonary regurgitant velocity. These estimates of pulmonary artery pressures are derived from a modification of the Bernoulli equation using the 4V2 formula to represent the difference between the right ventricular and right atrial pressure, or the difference between the pulmonary artery and right ventricular pressure at end diastole. Correlations > 0.95 have been achieved with underestimations of the pulmonary artery systolic pressure,12 and > 0.90 for pulmonary artery diastolic pressures.3 To actually estimate pulmonary artery systolic or diastolic pressure, the mean right atrial pressure has to be added. The recording of both pulmonary and tricuspid valve regurgitation provides the clinician with an estimate of pulmonary artery systolic and diastolic pressures.

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