USING CORONARY SINUS DIAMETER AND COLLAPSE INDEX TO ESTIMATE RIGHT
ATRIAL PRESSURE FOR ECHOCARDIOGRAPHIC SYSTOLIC PULMONARY ARTERIAL
PRESSURE MEASUREMENT
Abstract
Objective: According to Bernoulli Equation, systolic pulmonary artery
pressure is obtained echocardiographically by adding estimated right
atrial pressure (RAP) to the multiply of square of tricuspid
regurgitation flow rate by four. RAP is estimated based on inferior vena
cava (IVC) diameter and collapse. Our objective is to investigate
usability of coronary sinus(CS) diameter and collapse, measured by
echocardiography for estimating RAP. Methods: Our study is a single
center, prospective study. 136 patients, over 18 years of age and
without exclusion criteria, who admitted to Akdeniz University Hospital
Cardiology Department between March 2017 and March 2018 and were
scheduled to undergo right heart catheterization for any reason were
included study. Results: Patients were divided into two groups as
invasively measured RAP ≥10 mmHg (n: 57) and RAP <10 mmHg (n:
79). In group with RAP ≥10 mmHg, maximum IVC and CS diameter were higher
than group with RAP <10 mmHg, IVC and CS collapse indices were
lower (p <0.001). Optimal cut-off value for maximum IVC
diameter was 19.6 mm (sensitivity 63.2%, specificity 87.3%), for IVC
collapse index was 46.1 (sensitivity 75%, specificity 79.7%), for
maximum CS diameter was 11 mm (sensitivity 64.9%, specificity 77%),
for CS collapse index was 39.2 (sensitivity 75.4%, specificity 88.6%).
Conclusion: Significant relationship was found between invasively
measured RAP and maximum IVC diameter, collapse index and maximum CS
diameter and collapse index. Results of CS parameters were as
significant as results of IVC parameters therefore it shows that CS can
also be used for estimating RAP.