[Doppler echocardiography and hemodynamic parameters in congenital heart disease with increased pulmonary flow].

Background: The prediction of pulmonary hemodynamic data from non-invasive assessment could exempt some patients with congenital cardiac septal defects from preoperative invasive assessment (catheterization).

Objective: To determine, in simultaneous assessment, whether data obtained from Doppler echocardiography could predict aspects of pulmonary hemodynamics in such patients.

Methods: Echocardiographic parameters related to systolic and systemic pulmonary flow and pulmonary venous flow were related to hemodynamic data in 30 consecutive patients with cardiac septal defects (aged 4 months to 58 years, median 2.2 years, mean pulmonary artery pressure between 16 and 93 mmHg).

Results: The velocity-time integrals of systolic flow in right ventricle outflow tract (VTI RVOT > or = 22 cm) and pulmonary venous flow (VTI VP > or = 20 cm) predicted PVR/SVR <; 0.1 levels (pulmonary vascular resistance and systemic vascular resistance ratio), with a specificity of 0.81 and odds ratio above 1.0. For VTI RVOT > or = 27 cm and VTI PV > 24 cm values, the specificity was higher than 0.90 and odds ratio 2.29 and 4.47 respectively. The ratio between pulmonary and systemic flows (Qp/Qs > 2.89 and > or = 4.0, echocardiographic estimates) was useful in predicting Qp/Qs > 3.0 values through catheterization (specificity of 0.78 and 0.91, odds ratio 1.14 and 2.97, respectively).

Conclusion: In patients with cardiac septal defects, Doppler echocardiography is able to identify those at increased flow and low pulmonary vascular resistance.