Noninvasive and invasive evaluation of pulmonary arterial pressure in kyrgyz highlanders

¹ Institute of Molecular Biology and Medicine, Bishkek, Kyrgyzstan.
² National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyzstan.
³ Dept of Pathophysiology, Free University of Brussels, Brussels, Belgium.
⁴ Section of Experimental Medicine and Toxicology, Imperial College London, Hammersmith Hospital, London, United Kingdom.

^* To whom correspondence should be addressed. E-mail: m.wilkins{at}imperial.ac.uk.

	Abstract

The purpose of this study was to evaluate Doppler-echocardiography for the detection of pulmonary hypertension in high altitude inhabitants.

Sixty (55 male) patients aged 18 to 71 years were recruited from an electrocardiographic screening program applied to 1430 inhabitants living between 2500 and 3600 m in Kyrgyzstan. Forty-four met electrocardiographic criteria for right ventricular hypertrophy. All underwent a Doppler echocardiography followed by a cardiac catheterization within 7 days of arrival in Bishkek (760m). Pulmonary artery pressure was estimated from the pulmonary flow acceleration time and from the maximum velocity of tricuspid regurgitation.

Sufficient quality tricuspid regurgitant jets were recovered in only 28 % of the patients. Therefore, pulmonary artery pressure was estimated from the pulmonary flow acceleration time, which was recovered in 100 % of the patients. Thirty-seven of the patients (62%) had pulmonary hypertension on echocardiography. Pulmonary hypertension was confirmed in 29 on catheterization. Pulmonary hypertension was detected with 70% sensitivity and 88% specificity by echocardiography, as compared to 59 % sensitivity and 81 % specificity of electrocardiography. The correlation coefficient between echocardiography and catheterization studies was r²=0.78.

It is concluded that a combination of electrocardiography and echocardiography may be useful for the screening for high altitude pulmonary hypertension.

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