Frequency of Doppler measurable pulmonary artery pressures

The current literature suggests that right-sided heart pressures can be obtained noninvasively in approximately 60% of patients. We hypothesized that with a focused echocardiographic Doppler examination, measurable tricuspid or pulmonary valve regurgitation suitable for measuring pressures could be obtained in a higher percentage of patients. The study group consisted of 200 consecutive patients undergoing echocardiographic and Doppler hemodynamic evaluation. All patients were first examined by an ultrasonographer instructed to attempt to record tricuspid and pulmonary regurgitant velocities. After this examination, a designated cardiologist performed a focused examination with the intent of improving the signal quality and increasing the number of measurable signals for evaluation. Tricuspid regurgitation of measurable quality was recorded in 147 (73.5%) of 200 patients by the ultrasonographer; this result was improved to 172 patients (86%) by the designated cardiologist. Pulmonary regurgitation was obtainable in 147 (95%) of 154 patients and was of measurable quality in 137 (89%). When results of tricuspid and pulmonary regurgitation were combined, a quantifiable signal was obtained in 194 (97%) of 200 consecutive unselected patients. This study demonstrates that a well-trained ultrasonographer or echocardiologist can obtain right-sided pressures in at least 95% of all unselected cardiovascular patients.