Radioechocardiography in the evaluation of pulmonary hypertension

Aim. To study the capabilities of radioechocardigraphy in the evaluation of pulmonary hypertension of various causes, early non-invasive detection of pressure increase in the pulmonary artery.

Methods. The study included 800 patients with congenital (269) and acquired (217) mitral valve diseases, pulmonary embolism (140), primary pulmonary hypertension (57), coronary heart disease with acute myocardial infarction (117) of different age and gender. Digital radiography, linear tomography of chest, ECG, echocardiography, multidetector computed tomography angiography, and ultrasound of inferior vena cava were performed.

Results. Radiocardiography combined with linear tomography and measurement of Moore index, right atrium index, transpulmonary distance, and width of right descending pulmonary artery at the level of intermediate bronchus, allows determining the degree, type (arterial, venous, capillary, and mixed) and cause of pulmonary hypertension. Digital radiography and linear tomography in 80% cases reveal signs of pulmonary embolism. Echocardiography makes it possible to study hemodynamics in pulmonary hypertension, to detect the dilation of the right heart, inferior vena cava, and renal veins, and to calculate the systolic pressure in the right ventricle, pulmonary artery, and right atrium. Radioechocardigraphy allows determining the cause and degree of pulmonary hypertension, and hemodynamic disorders. Sensitivity of the method for diagnosis of pulmonary hypertension is 89%, specificity is 90%, and precision is 92%.

Conclusion. Radioechocardigraphy is a highly effective method for diagnosis of pulmonary hypertension; ultrasound of inferior vena cava, iliac veins, and veins of the lower limbs allows to determine the source of pulmonary embolism, to diagnose embologenicity of thromboses and to evaluate the need for vena cava filters.