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Pulmonary artery pulse pressure and wave reflection in chronic pulmonary thromboembolism and primary pulmonary hypertension

Vincent Castelain, MD^* , Philippe Hervé, MD^*, Yves Lecarpentier, MD, PhD , Pierre Duroux, MD^*, Gerald Simonneau, MD^* and Denis Chemla, MD, PhD

^* Service de Pneumologie, Hôpital Antoine Béclère, Université Paris-XI, Assistance Publique-Hôpitaux de Paris, Clamart, France
Service d’Explorations Fonctionnelles Cardio-Respiratoires, CHU de Bicêtre, Université Paris-XI, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre, France
Inserm-Loa-Ensta-Ecole Polytechnique, Palaiseau, France

View larger version (13K): [in a new window]   Figure 1 Typical pulmonary artery pressure tracings. DPAP = diastolic pulmonary artery pressure; PAPP = pulmonary artery pulse pressure; Pi = pulmonary artery pressure at the inflexion point; SPAP = systolic pulmonary artery pressure; Ti = transit time. For Pi and Ti calculations, see Methods section.

View larger version (15K): [in a new window]   Figure 2 Illustration of pulmonary artery pressure waveforms in each of the 14 patients under study. CPTE = chronic pulmonary thromboembolism (n = 7); PPH = primary pulmonary hypertension (n = 7). Recording time = 2 s for each trace.

View larger version (10K): [in a new window]   Figure 3 Mean pulmonary artery pressure (MPAP), pulmonary artery pulse pressure (PAPP) and normalized pulmonary artery pulse pressure (PAPP/MPAP) in chronic pulmonary thromboembolism (CPTE) (open circles) and in primary pulmonary hypertension (PPH) (closed circles). Individual data points and means ± SD are indicated.

View larger version (10K): [in a new window]   Figure 4 Augmentation index (left panel), transit time (Ti) (middle panel) and normalized transit time (right panel) in chronic pulmonary thromboembolism (CPTE) (open circles) and in primary pulmonary hypertension (PPH) (solid circles). b.s.a. = body surface area; Pi = pulmonary artery pressure at the inflexion point; SPAP = systolic pulmonary artery pressure. Individual data points and means ± SD are indicated. Two patients with CPTE had almost identical Ti values and Ti/b.s.a. values.