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Updated: Jun 19, 2026
Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
Published on: October 28, 2020
Doppler echocardiography can provide a comprehensive assessment of right ventricular afterload
Odd Bech-Hanssen1, Nedim Selimovic, Bengt Rundqvist
1Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden. odd.bech-hanssen@klinfys.gu.se
Insights
Doppler echocardiography accurately assesses right ventricular afterload, including pulmonary artery mean pressure (PAMP) and pressure waveforms. This non-invasive method provides a comprehensive evaluation comparable to invasive catheterization.
Area of Science:
- Cardiology
- Medical Imaging
- Hemodynamics
Background:
- Right ventricular (RV) afterload is crucial for cardiac function.
- Accurate assessment of RV afterload, including pulmonary artery (PA) pressure, is vital.
- Current methods for assessing RV afterload can be invasive.
Purpose of the Study:
- To evaluate novel Doppler echocardiographic methods for assessing RV afterload.
- To determine the accuracy of Doppler echocardiography in measuring pulmonary artery mean pressure (PAMP) and the PA pressure waveform.
Main Methods:
- 109 patients underwent simultaneous or non-simultaneous right-heart catheterization and Doppler echocardiography.
- Pulsed Doppler in the PA and continuous Doppler of tricuspid regurgitation were used.
- PA pressures and waveform characteristics were derived and analyzed.
Main Results:
- Strong correlation (R=0.85) between catheter-derived and Doppler-derived PA systolic pressure.
- No significant difference between catheter PAMP (39 ± 18 mm Hg) and Doppler PAMP (39 ± 15 mm Hg).
- Comparable systolic and diastolic areas under the PA pressure curves between methods.
Conclusions:
- Doppler echocardiography offers a comprehensive assessment of RV afterload.
- This includes PAMP and the PA pressure waveform.
- The method is effective across a wide range of PA pressures and diagnoses.
Background:
The purpose of this study was to evaluate novel Doppler echocardiographic methods for a comprehensive assessment of right ventricular afterload, including pulmonary artery (PA) mean pressure (PAMP) and the PA pressure waveform.
Methods:
The study comprised 109 patients who underwent right-heart catheterization simultaneously (group A, n = 31) with Doppler echocardiography on 35 occasions or nonsimultaneously (group B, n = 78) within 24 hours of Doppler echocardiography. Right ventricular afterload variables were obtained using pulsed Doppler in the PA and continuous Doppler of tricuspid regurgitation. The intervals from QRS to the opening and closing of the pulmonary valve and to the peak velocity of tricuspid regurgitation were measured. PA end-diastolic pressure, PA systolic pressure, and PA notch pressure were calculated. The Doppler-derived pressure curve was separated into 3 parts with fitted second-order curves.
Results:
Catheter PAMP and Doppler PA systolic pressure in group A were strongly related (R = 0.85). The regression equation from group A (PAMP = 0.65 x Doppler PA systolic pressure - 1.2 mm Hg) was used to calculate PAMP in group B. There was no difference between catheter PAMP (mean, 39 +/- 18 mm Hg; range, 8-95 mm Hg) and Doppler PAMP (mean, 39 +/- 15 mm Hg; range, 12-83 mm Hg) (P = .85). The systolic areas under the curves for catheter and Doppler PAMP in group A were 20 +/- 4.7 and 20 +/- 4.0 mm Hg s, respectively (P = .52), and the diastolic areas were 21 +/- 5.7 and 22 +/- 6.3 mm Hg s, respectively (P = .21).
Conclusion:
A comprehensive assessment of right ventricular afterload that includes PAMP and the PA pressure waveform can be provided by Doppler echocardiography in patients with a wide range of PA pressures and different diagnoses.
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