Application of superior vena cava spectra in prediction of pulmonary hypertension / 中华超声影像学杂志

ABSTRACT

Objective To analyze the changes of superior vena cava SVC spectra in patients with pulmonary hypertension PH and screen the proper parameters of SVC to predict PH Methods Eighty patients with congenital heart disease who underwent right heart catheterization for the measurement of pulmonary artery pressure were included SVC Doppler ultrasound was performed before the catheterization The cut-off point of SVC parameters in the prediction of PH was analyzed using receiver operator characteristic curve ROC curve Results Eighty subjects were included and there were 61 patients in PH group and 10 patients in the control group whose spectra pattern had four waves The data of the 9 subjects whose SVC spectrum were not four waves were excluded from the analysis Diagnostic criteria for PH was pulmonary artery systolic pressure PASP more than 30 mmHg measured by right heart catheterization The analysis of the peak velocity of SVC waves showed that ventricular systolic wave S reduced ventricular reversal wave VR reduced and the ratio of atrial reversal wave and ventricular systolic wave AR S increased in the PH group Compared with the control group their differences were statistically significant t =2 244 2 063 -2 896 P =0 028 0 043 0 005 The ROC curve showed that the ratio of AR S had better diagnostic effect than other parameters On the ROC curve of AR S when the ratio of AR S was 0 45 the sensitivity was 73 77% and specificity was 80 00% respectively for predicting PH When AR S was used to distinguish the control group from patients with moderate and severe PH group the sensitivity was 82 86% and specificity was 80 00% respectively Conclusions Using the ratio of AR S 0 45 as a cut-off for prediction of PH shows a good sensitivity and specificity which might be an alternative method for assessing PH alternative method for assessing PH.