Ahmadou Musa Jingi*, Liliane Mfeukeu Kuate, Jean Jacques Noubiap, Chris Nadege Nganou, Sylvie Ndongo Amougou, Aurel Tankeu, Ba Hamadou, Alain Menanga, Samuel Kingue.

Authors’ affiliation: Department of Internal Medicine and Specialties. Faculty of Medicine and Biomedical Sciences. University of Yaoundé 1. Cameroon.

Corresponding author:

Abstract

Background: Echocardiography is widely used to estimate pulmonary artery pressure because of its availability, accessibility, and affordability. Tricuspid regurgitant jet velocity (TRV) and pulmonary acceleration time (PAT) are indirect echocardiographic techniques in use.

Aim: Compare the performance and agreement of TRV and PAT in estimating pulmonary artery pressure.

Methods: We carried out a cross-sectional study at the Yaounde central hospital between October and December 2016. We compared the odds of having high pulmonary artery pressure estimated using TRV > 2.8 m/s and PAT < 120 ms in multivariate analysis. We compared the agreement between the methods using Bland-Altman plots.

Results: We recruited 134 participants–57 (42.5%) males. Their mean age (SD) was 55.9 (15.6) years. Hypertension was seen in 60 (44.8%), diabetes in 13 (9.7%), stroke in 7 (5.2%), and heart failure in 25 (18.7%). Left ventricular geometry was normal in 92 (68.7%), concentric remodeling in 17 (12.7%), concentric LVH in 11 (8.2%), and eccentric LVH in 14 (10.4%) participants. Left ventricular function was normal (≥50%) in 120 (89.6%), intermediate (40 – 49%) in 6 (4.5%), and low (<40%) in 8 (6%) participants. Pulmonary acceleration time (PAT) <120 ms was seen in 78 (58.2%) participants, and Tricuspid regurgitant velocity (TRV) > 2.8 m/s was seen in 73 (54.5%) participants. The concordance–present/present (53) and absent/absent (36)–between PAT and TRV was 66.4%. Only PAT was significantly associated with age > 55 years (aOR : 2.8, p=0.004), LVH (aOR:6.7, p=0.003), left atrial pressure >15 mmHg (aOR:6.6, p=0.009), and TAPSE<16mm (aOR:9.3, p=0.009). Only TRV was significantly associated with RA dilation (aOR: 3.7, p=0.006). Both PAT (aOR: 14.9, p=0.001) and TRV (aOR: 5.7, p=0.008) were significantly associated with RV dilation.

Conclusion: PAT was more likely to be abnormal than TRV, and this was associated with many morbid conditions of the heart structure and function.

Keywords: Pulmonary Artery Pressure, Echocardiography, Tricuspid regurgitant velocity, Pulmonary acceleration time.