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Elucidating tricuspid Doppler signal interpolation and its implication for assessing pulmonary hypertension
Department of Cardiothoracic Surgery Stanford University School of Medicine Stanford California USA;Cardiovascular Institute Stanford University Stanford California USA.ORCID iD: 0000-0001-6867-8270
Department of Medicine, Division of Cardiovascular Medicine Stanford University School of Medicine Stanford California USA;Department of Cardiothoracic Surgery Hospital Bichat Paris France;INSERM U1148, Cardiovascular Bioengineering Paris France.ORCID iD: 0000-0002-9572-5877
Cardiovascular Institute Stanford University Stanford California USA;Department of Medicine, Division of Cardiovascular Medicine Stanford University School of Medicine Stanford California USA;KU Leuven Department of Cardiovascular Sciences, Research Unit Hypertension and Cardiovascular Epidemiology University of Leuven Leuven Belgium.ORCID iD: 0000-0003-4821-5249
Department of Pediatrics Division of Pediatric Cardiology, Stanford University School of Medicine Palo Alto California USA;Department of Bioengineering Stanford University School of Medicine Stanford California USA.ORCID iD: 0000-0002-5676-6561
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2022 (English)In: Pulmonary Circulation, ISSN 2045-8932, E-ISSN 2045-8940, Vol. 12, no 3, p. e12125-Article in journal (Refereed) Published
Abstract [en]

Doppler echocardiography plays a central role in the assessment of pulmonary hypertension (PAH). We aim to improve quality assessment of systolic pulmonary arterial pressure (SPAP) by applying a cubic polynomial interpolation to digitized tricuspid regurgitation (TR) waveforms. Patients with PAH and advanced lung disease were divided into three cohorts: a derivation cohort (n = 44), a validation cohort (n = 71), an outlier cohort (n = 26), and a non-PAH cohort (n = 44). We digitized TR waveforms and analyzed normalized duration, skewness, kurtosis, and first and second derivatives of pressure. Cubic polynomial interpolation was applied to three physiology-driven phases: the isovolumic phase, ejection phase, and “shoulder” point phase. Coefficients of determination and a Bland−Altman analysis was used to assess bias between methods. The cubic polynomial interpolation of the TR waveform correlated strongly with expert read right ventricular systolic pressure (RVSP) with R2 > 0.910 in the validation cohort. The biases when compared to invasive SPAP measured within 24 h were 6.03 [4.33; 7.73], −2.94 [1.47; 4.41], and −3.11 [−4.52; −1.71] mmHg, for isovolumic, ejection, and shoulder point interpolations, respectively. In the outlier cohort with more than 30% difference between echocardiographic estimates and invasive SPAP, cubic polynomial interpolation significantly reduced underestimation of RVSP. Cubic polynomial interpolation of the TR waveform based on isovolumic or early ejection phase may improve RVSP estimates.

Place, publisher, year, edition, pages
Wiley , 2022. Vol. 12, no 3, p. e12125-
Keywords [en]
pulmonary hypertension, ultrasound, Doppler
National Category
Medical Imaging
Research subject
Medical Technology
Identifiers
URN: urn:nbn:se:kth:diva-328192DOI: 10.1002/pul2.12125ISI: 000843054900001PubMedID: 36016669Scopus ID: 2-s2.0-85139145339OAI: oai:DiVA.org:kth-328192DiVA, id: diva2:1762755
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QC 20230607

Available from: 2023-06-05 Created: 2023-06-05 Last updated: 2025-02-09Bibliographically approved

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Dual, Seraina A.

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Dual, Seraina A.Verdonk, ConstanceAmsallem, MyriamPham, JonathanMcElhinney, Doff B.Arunamata, AlisaFeinstein, Jeffrey A.Marsden, AlisonHaddad, François
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Pulmonary Circulation
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