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Echocardiographic assessment of pulmonary hypertension: a guideline protocol from the British Society of Echocardiography

An Erratum to this article was published on 01 September 2019

This article has been updated

Abstract

Pulmonary hypertension is defined as a mean arterial pressure of ≥25 mmHg as confirmed on right heart catheterisation. Traditionally, the pulmonary arterial systolic pressure has been estimated on echo by utilising the simplified Bernoulli equation from the peak tricuspid regurgitant velocity and adding this to an estimate of right atrial pressure. Previous studies have demonstrated a correlation between this estimate of pulmonary arterial systolic pressure and that obtained from invasive measurement across a cohort of patients. However, for an individual patient significant overestimation and underestimation can occur and the levels of agreement between the two is poor. Recent guidance has suggested that echocardiographic assessment of pulmonary hypertension should be limited to determining the probability of pulmonary hypertension being present rather than estimating the pulmonary artery pressure. In those patients in whom the presence of pulmonary hypertension requires confirmation, this should be done with right heart catheterisation when indicated. This guideline protocol from the British Society of Echocardiography aims to outline a practical approach to assessing the probability of pulmonary hypertension using echocardiography and should be used in conjunction with the previously published minimum dataset for a standard transthoracic echocardiogram.

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Funding

The publication of this article was sponsored by Actelion Pharmaceuticals Ltd. The article was produced by the British Society of Echocardiography independently of Actelion Pharmaceuticals Ltd, and they were not able to influence its content. Peer review was carried out independently by the journal’s editorial board, based on scientific merit alone.

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Correspondence to Daniel X. Augustine MD.

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(D Augustine is the Lead Author)

(Guideline Chairs: T Mathew and V Sharma)

The publication of this article was sponsored by Actelion Pharmaceuticals Ltd. The article was produced by the British Society of Echocardiography independently of Actelion Pharmaceuticals Ltd and they were not able to influence its content. Peer review was carried out independently by the journal’s editorial board, based on scientific merit alone.

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Augustine, D.X., Coates-Bradshaw, L.D., Willis, J. et al. Echocardiographic assessment of pulmonary hypertension: a guideline protocol from the British Society of Echocardiography. Echo Res Pract 5, G11–G24 (2018). https://doi.org/10.1530/ERP-17-0071

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Key Words

  • pulmonary hypertension
  • echocardiography
  • guideline