Non-invasive diagnosis of pulmonary hypertension in chronic obstructive pulmonary disease. Comparison of ECG, radiological measurements, echocardiography and myocardial scintigraphy. European journal of respiratory diseases. [Eur J Respir Dis] Journal article | | Title | Non-invasive diagnosis of pulmonary hypertension in chronic obstructive pulmonary disease. Comparison of ECG, radiological measurements, echocardiography and myocardial scintigraphy. | | Author(s) | Oswald-Mammosser M, Oswald T, Nyankiye E, Dickele MC, Grange D, Weitzenblum E | | Institution | Pulmonary Function Laboratory, University Hospital, Strasbourg, France. | | Source | Eur J Respir Dis 1987 Nov; 71(5):419-29. | | MeSH | Adult
Aged
Echocardiography
Electrocardiography
Heart
Humans
Hypertension, Pulmonary
Lung Diseases, Obstructive
Male
Middle Aged
Respiratory Function Tests
| | Abstract | The respective value of four non-invasive methods for the diagnosis of pulmonary arterial hypertension (PAH) was investigated in 63 COPD patients, using right heart catheterization as the reference method: 22 patients had no resting PAH (pulmonary artery mean pressure (PAP) less than or equal to 20 mmHg); 26 patients had mild PAH (PAP = 21-30 mmHg); and 15 patients had moderate to severe PAH (PAP greater than 30 mmHg). The specificity of ECG was 86% and the sensitivity 51% (only 38% in mild PAH). The specificity of radiological measurements was 63% and the sensitivity 46% (38% in mild PAH). Echocardiography (echo) had the best results with a specificity of 75% and a sensitivity of 78% (73% in mild PAH), but reliable echo measurements were available in only 52 out of 63 patients. Myocardial scintigraphy had a specificity of 68% and a sensitivity of 66% (58% in mild PAH). A stepwise regression analysis (including one echo, one ECG, one radiological and one functional variable) explained only 43% of the variance of PAP (multiple r = 0.66). These results suggest that no individual method is sufficiently reliable for predicting the presence of PAH, and particularly mild PAH, but the combination of echo + myocardial scintigraphy allows the prediction of PAH with a good probability. The precise level of PAH cannot be estimated, even when using multiple regression equations. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 3443164 |
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