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Related Experiment Video

Updated: Sep 11, 2025

Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery
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Right Ventricular Outflow Tract Velocity Time Interval: An Invaluable Yet Forgotten Echocardiographic Variable.

Khalid Sawalha1, Srikanth Vallurupalli1, Angel López-Candales2

  • 1Cardiovascular Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.

Echocardiography (Mount Kisco, N.Y.)
|August 13, 2025
PubMed
Summary
This summary is machine-generated.

The RVOT VTI/PVR ratio may be a more effective echocardiographic tool than TAPSE/PASP for assessing right ventricular-pulmonary artery coupling. This new ratio offers potentially more reliable hemodynamic data, especially when TAPSE has limitations.

Keywords:
dopplerechocardiographypulmonary hypertensionright ventricleright ventricular systolic functionvelocity time integral

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Area of Science:

  • Cardiovascular Imaging
  • Echocardiography
  • Pulmonary Hypertension

Background:

  • Echocardiography is crucial for assessing right ventricular outflow tract (RVOT) function and pulmonary artery (PA) flows.
  • The Tricuspid Annular Plane Systolic Excursion (TAPSE)/Pulmonary Artery Systolic Pressure (PASP) ratio is currently the standard noninvasive measure for evaluating RV hemodynamics.
  • Limitations exist with TAPSE in certain clinical scenarios, necessitating exploration of alternative metrics.

Purpose of the Study:

  • To investigate the relationship between RVOT Velocity Time Integral (VTI) Doppler measurements and TAPSE/PASP ratios.
  • To determine potential echocardiographic alternatives for assessing RV-PA coupling across varying left ventricular (LV) ejection fractions and PASP levels.

Main Methods:

  • Analysis of RVOT VTI Doppler measurements in relation to TAPSE/PASP ratios.
  • Determination of cutoff values for RVOT VTI based on PA-RV hemodynamics.
  • Comparison of RVOT VTI/Pulmonary Vascular Resistance (PVR) ratio against TAPSE/PASP.

Main Results:

  • Established cutoff values for RVOT VTI: >13 cm for TAPSE >2 cm, and >15 cm if PASP <35 mmHg or PVR <1.6 WU.
  • Found no significant correlation between RVOT VTI and the TAPSE/PASP ratio.
  • Identified the RVOT VTI/PVR ratio as a potentially superior echocardiographic alternative for assessing RV-PA coupling.

Conclusions:

  • Despite overlapping information, RVOT VTI and TAPSE, along with PASP and PVR, exhibit distinct anatomical and functional properties.
  • The RVOT VTI/PVR ratio may offer more reliable hemodynamic assessment compared to TAPSE/PASP, particularly when TAPSE is limited.
  • Further prospective studies are required to validate the clinical utility of the RVOT VTI/PVR ratio.