Estimated right ventricular systolic pressure by echocardiogram showed a moderate correlation with pulmonary artery systolic pressure by right heart catheterization (Spearman coefficient 0.58, p<0.001).
Observational (n=2,468)
Does estimated right ventricular systolic pressure by echocardiogram accurately correlate with pulmonary artery systolic pressure by right heart catheterization in patients with and without pulmonary physiologic decrements?
Echocardiography-estimated RVSP shows only moderate correlation with RHC-measured PASP, with nearly half of patients having >10mmHg discordance, regardless of underlying pulmonary physiologic decrements.
Effect estimate: Spearman coefficient 0.58
p-value: p=< 0.001
Abstract Rationale Right heart catheterization (RHC) is the gold standard for measurement of pulmonary artery systolic pressure (PASP). Echocardiography is used to estimate right ventricular systolic pressure (eRVSP) which is equivalent to PASP in most instances. Prior studies with small sample sizes demonstrated moderate correlations between RHC PASP and eRVSP. Our study used a large database from a quaternary health system to evaluate the correlation between PASP and eRVSP for the general patient population, as well as those with physiologic pulmonary obstruction, restriction, or both. Methods Data source for this study was Mass General Brigham’s Research Patient Data Registry. All patients who underwent at least one RHC from 2010 to 2023 were systematically identified. Those with at least one corresponding echocardiogram and full pulmonary function test (PFT) between 360 days before to 180 days after the date of RHC were included. Unstructured RHC, echocardiogram, and PFT data were cleaned and extracted using a generative artificial intelligence pipeline published previously. Obstructive lung disease (OLD) was defined as forced expiratory volume in 1 second over forced vital capacity (FEV1/FVC) ratio of less than 70% by PFT. Restrictive lung disease (RLD) was defined as total lung capacity less than 80% predicted. Patients who met both criteria had combined OLD and RLD. Continuous variables were summarized using mean and standard deviation, while categorical variables by proportion. The correlation between PASP and eRVSP was expressed as a Spearman coefficient. Results Among 2468 patients who met the inclusion criteria, mean age was 63.1 (15.1). 1423 (57.7%) were male and 2137 (86.6%) were white. Mean PASP by RHC was 44.7 (17.8) mmHg while mean eRVSP by echocardiogram was 44.7 (17.2) mmHg, with a mean difference of 0.05 (15.4). 1174 (47.6%) patients had differences greater than 10mmHg in either direction. 536 (21.7%) patients had OLD, 894 (36.2%) RLD, and 189 (7.7%) had both. The overall correlation between PASP and eRVP was 0.58 (p 0.001). Correlations were 0.59 (p 0.001) in OLD patients, 0.53 (p 0.001) in RLD patients, and 0.57 (p 0.001) in patients with combined OLD and RLD. Conclusions Using a large health system database, we demonstrated a moderate correlation between PASP measured by RHC and eRVSP by echocardiogram, similar to results from prior smaller studies. This correlation does not change substantially when stratified by different types of pulmonary physiologic decrements. Additional large-scale studies are required to identify patient or system risk factors that can lead to discordance between PASP and eRVSP. This abstract is funded by: None
Shen et al. (Fri,) conducted a observational in Pulmonary physiologic decrements (n=2,468). Echocardiography (eRVSP) vs. Right heart catheterization (PASP) was evaluated on Correlation between PASP and eRVSP (Spearman coefficient 0.58, p=< 0.001). Estimated right ventricular systolic pressure by echocardiogram showed a moderate correlation with pulmonary artery systolic pressure by right heart catheterization (Spearman coefficient 0.58, p<0.001).