Echocardiography versus right heart catheterization in class I pulmonary hypertension

It has been agreed that pulmonary hypertension should be determined by right heart catheterization. However, being invasive and refused by many patients, echocardiography was thought to be a reasonable substitute to determine a solid diagnosis of pulmonary arterial hypertension. So fourteen patients with pulmonary arterial hypertension (class I) were studied by estimating pulmonary artery systolic pressure by both transthoracic echocardiography and right heart catheterization using Swan-Ganz catheter. The patients were 4 males and 10 females with mean ages about 46.25 ± 23.33 in males and 36.8 ± 11.63 in females (total mean age was about 39.5 ± 15.46 years). Mean value of the Echo SPAP: 82.79 + 34.25 mmHg, however in the RHC SPAP 76.21 + 24.97.Comparing both clinical procedures via the Altman and Bland statistical method showed discrepancy between both procedures. Results showed that the 6MWD (mean + SD 262.64 ± 85.98) is significantly correlated with the mean pulmonary arterial pressure only.Conclusion: Echocardiography cannot be reliable alone in the proper decision making of diagnosis and management of pulmonary arterial hypertension.