Correspondence on 'Echocardiographic estimation of pulmonary pressure in patients with severe tricuspid regurgitation by Lemarchand et al

Lemarchand et al1 address an everyday question in the echocardiography laboratories about the reliability of systolic pulmonary artery pressure (sPAP) estimation in cases of severe tricuspid regurgitation (TR). It is concluded that sPAP is underestimated in cases of massive or torrential TR (TR-V), high right atrial (RA) pressure and ‘V-wave cut-off’sign on echocardiography. The applicability of the simplified Bernoulli equation in patients with TR-V for sPAP estimation is unclear and has not been adequately studied. While some authors alert that sPAP may be underestimated,2 others argue against its use in cases of free-flow TR.3 4 Lemarchand et al hold that this misestimation is primarily determined by RA pressure underestimation. However, there are other arguments for this inaccuracy: first, the simplified Bernoulli equation only includes the convective term of the flow. As the tricuspid orifice becomes larger and non-restrictive, the convective component...

Source: Heart - February 12, 2024 Category: Cardiology Authors: Gual-Capllonch, F., Pericas, P. Tags: Correspondence Source Type: research