RESUMO
INTRODUCTION: Pulmonary hypertension (PH) is common complication in advanced lung disease. Echocardiography provides additional information and may be useful to assess PH probability. OBJECTIVES: The usefulness of combination of well-known echocardiographic parameters in detecting PH in patients with advanced lung disease referred for lung transplantation was evaluated. METHODS: The study population consisted of 37 consecutive patients with idiopathic pulmonary fibrosis (IPF), 20 patients with chronic obstructive pulmonary disease (COPD), and 8 patients with other interstitial lung diseases. PH was defined as mean pulmonary arterial pressure (mPAP) ≥25 mm Hg diagnosed by cardiac catheterization. RESULTS: PH was present in 67.6% of enrolled IPF patients, 30% of enrolled COPD patients, and 75% of patients with other interstitial lung diseases. The receiver operating characteristics (ROC) curve analysis demonstrated right ventricular systolic pressure (RVSP) ≥43 mm Hg to be the threshold for PH prediction (n = 37, sensitivity 92.3%, specificity 81.8%, area under curve (AUC) 0.84, 95% confidence interval (CI) 0.67-1.0; P = .019). Right ventricular outflow tract (RVOT) diameter ≥34 mm and tricuspid annular plane systolic excursion (TAPSE) ≤18 mm had acceptable sensitivity, specificity and AUC (n = 65, 62.2%, 89.3%, 0.77, 95% CI 0.66-0.89; P = .11 and n = 62, 77.1%, 66.7%, 0.74, CI 0.61-0.87; P = .27, respectively). Combination of RVSP, RVOT and TAPSE, obtained in 36 patients, increased the sensitivity and negative predictive value (NPV) to 100%. CONCLUSIONS: In patients with advanced lung diseases referred for lung transplantation the combination of RVSP, RVOT diameter, and TAPSE may be helpful in PH exclusion.