Hemodynamic Assessment to Evaluate Pulmonary Hypertension in Patients with Aortic Stenosis

Pulmonary hypertension (PHT) is highly prevalentin patients with Aortic Stenosis (AS) and significantly increasesmortality. Correlation between echocardiogram derived rightventricular pressure and measured pulmonary artery systolicpressure (PASP) by right heart catheterization (RHC) have beenreported to be poor. Retrospective data of 56 patients with ASwho underwent coronary angiography and RHC from June 1999to 2008 were reviewed. 20 patients (35.1%) had severe PHT withPASP > 55 mmHg on RHC. PASP did correlate with the bodyweight (r = 0.473, p<0.01). There was a significant correlationbetween PASP on RHC and RVSP on echo (r = 0.344 p<0.01) buta Bland-Altman plot showed poor association. In patients withPVR < 3, there was correlation between the PASP and LVEDPon RHC (r = 0.655, p<0.001). 34 patients had an estimated RVSP<40 mm Hg on echo and 9 (25.7%) of these patients had severePHT on RHC. Using a RVSP cutoff of 40 mmHg, echo had 46.8%sensitivity. There was higher mortality at 3 years in patients withsevere PHT (44% vs. 10.7%, p