Blood pressure changes during routine transthoracic echocardiography

Area of Science:

• Cardiology
• Medical Imaging
• Physiology

Background:

• Increased afterload impacts flow-dependent metrics in transthoracic echocardiography (TTE), particularly for valvular heart disease evaluation.
• A single blood pressure (BP) measurement may not accurately represent the afterload during TTE imaging.
• Assessing BP changes during TTE is crucial for accurate interpretation of flow-dependent assessments.

Purpose of the Study:

• To evaluate the magnitude of blood pressure changes at discrete timepoints during routine transthoracic echocardiography.
• To determine if a single BP measurement accurately reflects the afterload during TTE.
• To investigate the implications of BP variability on valvular heart disease assessment.

Main Methods:

• Prospective study design.
• Automated BP measurements taken at 10-minute intervals during clinically indicated TTE.
• Inclusion of 50 participants (66% male, mean age 64 years).

Main Results:

• 80% of participants experienced a >10 mmHg drop in systolic BP within 10 minutes.
• Significant decreases observed in both systolic (mean 20.0 ± 12.8 mmHg) and diastolic BP (mean 15.7 ± 13.2 mmHg) at 10 minutes (P < 0.05).
• Systolic BP remained significantly different from baseline throughout the study duration.

Conclusions:

• Blood pressure recorded immediately before TTE is not a reliable indicator of afterload during the procedure.
• BP variability during TTE can lead to under- or over-estimation of valvular heart disease severity.
• Current TTE imaging protocols relying on flow-dependent metrics may require adjustments to account for intra-study BP fluctuations.