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Echocardiographic probability of pulmonary hypertension

Echocardiographic probability of pulmonary hypertension
Table A:
Echocardiographic probability of PH in symptomatic patients with a suspicion of PH
Peak tricuspid regurgitation velocity (m/s) Presence of other echo "PH signs"* Echocardiographic probability of PH
≤2.8 or not measurable No Low
≤2.8 or not measurable Yes Intermediate
2.9 to 3.4 No
2.9 to 3.4 Yes High
>3.4 Not required
Table B:
Additional echocardiographic signs suggestive of PH
A: The ventricles B: Pulmonary artery C: IVC and RA
RV/LV basal diameter/area ratio >1.0 RVOT AT <105 ms and/or midsystolic notching IVC diameter >21 mm with decreased inspiratory collapse (<50% with a sniff or <20% with quiet inspiration)
Flattening of the interventricular septum (LVEI >1.1 in systole and/or diastole) Early diastolic pulmonary regurgitation velocity >2.2 m/s RA area (end-systole) >18 cm2
TAPSE/sPAP ratio <0.55 mm/mmHg PA diameter >AR diameter PA diameter >25 mm  

PH: pulmonary hypertension; PA: pulmonary artery; IVC: inferior vena cava; RA: right atrium; RV: right ventricle; LV: left ventricle; RVOT AT: right ventricular outflow tract acceleration time; LVEI: left ventricle eccentricity index; TAPSE: tricuspid annular plane systolic excursion; sPAP: systolic pulmonary arterial pressure; AR: aortic root.

* Refer to Table B.

¶ Echocardiographic signs from at least 2 categories (A/B/C) must be present to alter the level of echocardiographic probability of PH.
Reproduced with permission of the © European Society of Cardiology & European Respiratory Society 2023: European Respiratory Journal 61 (1) 2200879; DOI: 10.1183/13993003.00879-2022. Published 6 January 2023.
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