Description of a characteristic sign of significant pulmonary hypertension with continuos Doppler

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Abstract

With the goal of determining if the presence of a notch followed by a telesystolic peak in the tricuspid regurgitation signal, is a sign of the presence and severity of pulmonary hypertension, 153 patients were studied with conventional Doppler echocardiography. While 36.7 % of them didn't have pulmonary hypertension, 28.1 % has mild, 26.1 % moderate and 9.1 % severe pulmonary hypertension. The sign studied here, was detected in 58 patients (37.9 %), 54 of whom had significant pulmonary hypertension (systolic pulmonary artery pressure> 50 mmHg) and only 4 patients has mild pulmonary hypertension. Thus, the sensibility was 100 %, specificity 95.9 %, and positive and negative predictive value was 93.8 % and 100 %, respectively. A possible explanation of the sign are the compensative mechanisms for right ventricular pressure generation, under elevated after load conditions, like the systolic interaction, interventricular septum mediated, which is reflected in a bifid rith ventricle pressure curve.