CORRELATION BETWEEN INVASIVE AND NON-INVASIVE PULMONARY PRESSURE ASSESSMENT IN LAGOS STATE UNIVERSITY TEACHING HOSPITAL
Authors & Affiliations
Oluwaseye M. Oladimeji¹, Alaba Oladimeji², Anthony G. Kweki³, Obawole M. Olalekan⁴, Adeola O. Ajibare⁵, Ramon K. Moronkola⁴, Esther O. Ijaola⁴, Oluwaseun O. Okunuga⁴, Ajibola Y. Sanda⁴, Onome A. Ehizojie⁴, Oluronke T. Bamgboye⁴, Kabirat I. Edun⁴, Aishah O. Salaudeen⁴, Timilehin E. Idowu⁴, Alaba P. Adebola⁴, Folashade A. Daniel⁵, Michael O. Balogun⁶, Tayo A. Addo⁷, Oladipupo Olafiranye⁷, Ijeoma Ekeruo⁸, Oluwaseyi Bolorunduro⁹, Obinnaya Emerole¹⁰ ¹ Internal Medicine, Lagos State University Teaching Hospital Hospital, Lagos, NGA; ² Cardiology, Lagos State University Teaching Hospital, Lagos, NGA; ³ Internal Medicine/Cardiology/ICENI Fellow, Colchester Hospital, ESNEFT, Colchester, GBR; ⁴ Internal Medicine, Lagos State University Teaching Hospital, Lagos, NGA; ⁵ Internal Medicine, Lagos State University College of Medicine, Lagos, NGA; ⁶ Internal Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, NGA; ⁷ Internal Medicine, The University of Texas Southwestern Medical Center, Texas, USA; ⁸ Internal Medicine, Texas Cardiac Arrhythmia, Texas, USA; ⁹ Department of Cardiology, Mary Washington Healthcare, Woodbridge, USA; ¹⁰ Internal Medicine, Georgia Heart Physicians Macon, Georgia, USA.
📖 Abstract Content
Pulmonary hypertension (PH) is associated with substantial morbidity and mortality. Although right heart catheterization (RHC) remains the gold standard for diagnosing PH, it is invasive and often unavailable in resource-limited settings. Echocardiography is widely used for non-invasive assessment, but its diagnostic performance relative to RHC has not been adequately validated in this setting.
In this prospective cross-sectional study, 102 patients with suspected PH were recruited. Participants underwent transthoracic echocardiography followed by RHC within one hour. PH was defined as a mean pulmonary arterial pressure >25 mmHg on RHC. Correlation and diagnostic accuracy analyses were performed.
Seventy-one participants completed both investigations. PH was identified in 48 (67.6%) participants by echocardiography and 39 (54.9%) by RHC. Echocardiographic pulmonary artery systolic pressure demonstrated a moderate positive correlation with invasive measurements (r = 0.635, p<0.001). Mean pulmonary artery pressure estimated using the Chemla and Syyed formulae showed the strongest correlation with invasive measurements (both r = 0.650, p<0.001), while pulmonary acceleration time-derived estimates demonstrated a weaker correlation (r = 0.473, p<0.001). Echocardiographic PASP demonstrated a sensitivity of 86.9%, specificity of 52.0%, positive predictive value of 76.9%, and negative predictive value of 68.4%.
Echocardiographic estimation of pulmonary arterial pressure demonstrated moderate agreement with invasive measurements and high sensitivity for detecting PH. While echocardiography is a valuable screening tool, RHC remains essential for definitive diagnosis.
