A simple echocardiographic score for the diagnosis of pulmonary vascular disease in heart failure

作者：D'Alto Michele^*; Romeo Emanuele; Argiento Paola; Pavelescu Adriana; D'Andrea Antonello; Di Marco Giovanni M; Iacono Agostino Mattera; Sarubbi Berardo; Rea Gaetano; Bossone Eduardo; Russo Maria G; Naeije Robert

来源：Journal of Cardiovascular Medicine, 2017, 18(4): 237-243.

DOI：10.2459/JCM.0000000000000485

• echocardiography
• pulmonary hypertension

Aims A simple echocardiographic score was designed for diagnosing precapillary vs postcapillary pulmonary hypertension and for discriminating between isolated postcapillary pulmonary hypertension (Ipc-PH) and combined precapillary and postcapillary pulmonary hypertension (Cpc-PH).
Methods The score comprised 7 points ( 2 for E/e' ratio <= 10, 2 for a dilated non-collapsible inferior vena cava, 1 for a left ventricular eccentricity index >= 1.2, 1 for a right-to-left heart chamber dimension ratio > 1 and 1 for the right ventricle forming the heart apex) and was applied to 230 consecutive patients referred for evaluation of pulmonary hypertension.
Results Precapillary pulmonary hypertension and postcapillary pulmonary hypertension were diagnosed in 160 and 70 patients, respectively. In the latter, Ipc-PHwas found in 51 and Cpc-PH in 19. The echo score was higher in precapillary vs postcapillary pulmonary hypertension patients ( 4.2 +/- 1.7 vs 1.6 +/- 1.7, P< 0.001) and in patients with Cpc-PH vs Ipc-PH ( 2.7 +/- 2.1 vs 1.2 +/- 1.3, P=0.001). The sensitivity and specificity of the echo score at least 2 for precapillary pulmonary hypertension were 99 and 54%, respectively ( area under the curve 0.85). In patients with postcapillary pulmonary hypertension, the sensitivity and specificity of the echo score at least 2 for Cpc-PH were 63 and 82% (area under the curve 0.73).
Conclusion A simple echocardiographic score helps in the differential diagnosis between precapillary and postcapillary pulmonary hypertension, and between Ipc-PH and Cpc-PH.

• 出版日期2017-4