Doppler‐derived pulmonary pulse transit time measurements in chronic obstructive pulmonary disease: Reproducibility and cardiopulmonary function

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Autores principales: Friederike Löffler, Mechthild Westhoff‐Bleck, Tobias Welte, Da‐Hee Park, Karen M Olsson, Lea Behrendt, Filip Klimeš, Johann Bauersachs, Frank Wacker, Gesa Helen Pöhler
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Publicado: Wiley 2024
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author Friederike Löffler
Mechthild Westhoff‐Bleck
Tobias Welte
Da‐Hee Park
Karen M Olsson
Lea Behrendt
Filip Klimeš
Johann Bauersachs
Frank Wacker
Gesa Helen Pöhler
author_facet Friederike Löffler
Mechthild Westhoff‐Bleck
Tobias Welte
Da‐Hee Park
Karen M Olsson
Lea Behrendt
Filip Klimeš
Johann Bauersachs
Frank Wacker
Gesa Helen Pöhler
Friederike Löffler
Mechthild Westhoff‐Bleck
Tobias Welte
Da‐Hee Park
Karen M Olsson
Lea Behrendt
Filip Klimeš
Johann Bauersachs
Frank Wacker
Gesa Helen Pöhler
collection Wiley Open Access
contents Doppler‐derived pulmonary pulse transit time measurements in chronic obstructive pulmonary disease: Reproducibility and cardiopulmonary function Friederike Löffler Mechthild Westhoff‐Bleck Tobias Welte Da‐Hee Park Karen M Olsson Lea Behrendt Filip Klimeš Johann Bauersachs Frank Wacker Gesa Helen Pöhler Echocardiography AbstractIntroductionDoppler‐derived pulmonary pulse transit time (pPTT) is an auspicious hemodynamic marker in chronic pulmonary diseases. The aim is to compare four distinct pPTT measurements and its relation to right cardiac and pulmonary function.MethodsProspectively, 25 chronic obstructive pulmonary disease (COPD) patients (four patients excluded) and 32 healthy subjects underwent repeated distinct pPTT measurements, standard echocardiography, and pulmonary function testing on the same day. pPTT was defined as the interval from the R or Q‐wave in the electrocardiogram to the corresponding pulse wave Doppler peak late systolic (S) 2 or diastolic (D) pulmonary vein flow velocity (pPTT R‐S, Q‐S, R‐D, Q‐D). Reproducibility was assessed using Bland–Altman analysis, coefficient of variation (COV), intraclass correlation coefficient (ICC), and power calculations. Associations with right ventricular RV tissue and pulse wave Doppler velocities (RV E', RV S', RV A', RV E, RV A, RV E/E', RV E/A), TAPSE, right ventricular fractional area change, left ventricular systolic and diastolic function (LV ejection fraction, E, A, E/A, E/E', septal E', lateral E'), LA diameters, as well as forced expiratory volume in 1 s, forced vital capacity (FVC) predicted (%), and in liters were analyzed.ResultsThere was no significant difference and no bias between pPTT measures (p range: .1–.9). COV was in COPD 1.2%–2.3%, in healthy subjects 1.0%–3.1%. ICC ranged from .92 (COPD) to .96 (healthy subjects). In COPD significant correlations were found for pPTT R‐S, Q‐S and R‐D with RV E`, (all > ρ: .49, < p = .0364), pPTT R‐S, Q‐S with RV E/E` (both > ρ: .49, < p = .0291), pPTT Q‐S with RV S´ (ρ: .58, p = .0134), RV A (ρ: .59, p = .0339) and heart rate > ρ: −.39, < p = .0297). pPTT R‐S, R‐D showed significant correlations with FVC predicted (%) (ρ: .48 p = .0224) and FVC (l) (ρ:.47 p = .0347).ConclusionsAll pPTT measures exhibited high reproducibility. In COPD patients pPTT measures correlate with diastolic right ventricular function. Defining Q as starting point seems clinically advantageous considering electromechanical desynchrony in patients with conduction disorders. 10.1111/echo.15821 http://creativecommons.org/licenses/by-nc-nd/4.0/
doi_str_mv 10.1111/echo.15821
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spellingShingle Doppler‐derived pulmonary pulse transit time measurements in chronic obstructive pulmonary disease: Reproducibility and cardiopulmonary function
Friederike Löffler
Mechthild Westhoff‐Bleck
Tobias Welte
Da‐Hee Park
Karen M Olsson
Lea Behrendt
Filip Klimeš
Johann Bauersachs
Frank Wacker
Gesa Helen Pöhler
Echocardiography
Doppler‐derived pulmonary pulse transit time measurements in chronic obstructive pulmonary disease: Reproducibility and cardiopulmonary function Friederike Löffler Mechthild Westhoff‐Bleck Tobias Welte Da‐Hee Park Karen M Olsson Lea Behrendt Filip Klimeš Johann Bauersachs Frank Wacker Gesa Helen Pöhler Echocardiography AbstractIntroductionDoppler‐derived pulmonary pulse transit time (pPTT) is an auspicious hemodynamic marker in chronic pulmonary diseases. The aim is to compare four distinct pPTT measurements and its relation to right cardiac and pulmonary function.MethodsProspectively, 25 chronic obstructive pulmonary disease (COPD) patients (four patients excluded) and 32 healthy subjects underwent repeated distinct pPTT measurements, standard echocardiography, and pulmonary function testing on the same day. pPTT was defined as the interval from the R or Q‐wave in the electrocardiogram to the corresponding pulse wave Doppler peak late systolic (S) 2 or diastolic (D) pulmonary vein flow velocity (pPTT R‐S, Q‐S, R‐D, Q‐D). Reproducibility was assessed using Bland–Altman analysis, coefficient of variation (COV), intraclass correlation coefficient (ICC), and power calculations. Associations with right ventricular RV tissue and pulse wave Doppler velocities (RV E', RV S', RV A', RV E, RV A, RV E/E', RV E/A), TAPSE, right ventricular fractional area change, left ventricular systolic and diastolic function (LV ejection fraction, E, A, E/A, E/E', septal E', lateral E'), LA diameters, as well as forced expiratory volume in 1 s, forced vital capacity (FVC) predicted (%), and in liters were analyzed.ResultsThere was no significant difference and no bias between pPTT measures (p range: .1–.9). COV was in COPD 1.2%–2.3%, in healthy subjects 1.0%–3.1%. ICC ranged from .92 (COPD) to .96 (healthy subjects). In COPD significant correlations were found for pPTT R‐S, Q‐S and R‐D with RV E`, (all > ρ: .49, < p = .0364), pPTT R‐S, Q‐S with RV E/E` (both > ρ: .49, < p = .0291), pPTT Q‐S with RV S´ (ρ: .58, p = .0134), RV A (ρ: .59, p = .0339) and heart rate > ρ: −.39, < p = .0297). pPTT R‐S, R‐D showed significant correlations with FVC predicted (%) (ρ: .48 p = .0224) and FVC (l) (ρ:.47 p = .0347).ConclusionsAll pPTT measures exhibited high reproducibility. In COPD patients pPTT measures correlate with diastolic right ventricular function. Defining Q as starting point seems clinically advantageous considering electromechanical desynchrony in patients with conduction disorders. 10.1111/echo.15821 http://creativecommons.org/licenses/by-nc-nd/4.0/
title Doppler‐derived pulmonary pulse transit time measurements in chronic obstructive pulmonary disease: Reproducibility and cardiopulmonary function
topic Echocardiography
url https://onlinelibrary.wiley.com/doi/10.1111/echo.15821