Role of Pulmonary Artery Acceleration Time in Detecting Pulmonary Hypertension and It’s Severity


Transthoracic echocardiography with Doppler study is recommended as the initial noninvasive test in the screening, evaluation & monitoring of pulmonary hypertension by estimating pulmonary artery systolic pressure by measuring PA acceleration time which can estimate pressure severity. The aim of this study is to estimate the validity of pulmonary artery acceleration time as an parameter for evaluation and measuring pulmonary artery systolic pressure . This study: A cross sectional study has been carried out from December 2015 to May 2016 in El-Imamein Al-Kadhimain teaching hospital at echocardiography 61 patients (both normal &abnormal pulmonary pressure). Patients at first were assessed for presence of TR to include in the study& both estimated systolic & mean pulmonary pressure were assessed by both TR derived Doppler assessment & then measuring PAAT & PAAT derived pulmonary pressure with comparison between them .It was shownIn this studythat61patients were involved regardless of pulmonary pressure,with mean age of 55.1±17.6 (range 18-85 yr), 18 were male (29.5%) & 43 were females (70.5%). The mean of estimated peak systolic pulmonary artery pressure(EPSPAP) & mean pulmonary arterial pressure (MPAP) derived from tricuspid regurgitation done was 44.9±20.2 mmHg& 32.1±14.2 respectively. The mean value of pulmonary artery acceleration time (PAAT)was 106.89± 27.5ms& mean of PAAT derived MPAP was 30.9 ± 12.35 mmHg .The correlation of pulmonary artery acceleration time (PAAT) to pulmonary systolic pressure shows a significant association (r= - 0.693)(p=0.001) & the correlation of PAAT derived MPAP to TR derived MPAP showed significant correlation P<0.001.The sensitivity and specificity of pulmonary acceleration time in detection of pulmonary hypertension (using the value of 100ms as a cut off value) found sensitivity of 100% and specificity of 63.1%. PAAT was more useful in detecting moderate & severe pulmonary hypertension P<0.001.conclusion:Pulmonary artery acceleration time is a noninvasive obtainable echocardiographic parameter well correlated with measures of pulmonary artery systolic &mean pressure derived by tricuspid regurgitation .