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Figure 1 Illustration of "Echo Right Heart Catheterization"
(A) Inferior vena caval (IVC) size and degree of collapse yields a range of right atrial pressure (RAP): <1.2 cm with full collapse = RAP 0 mm Hg; 1.2 to 1.7 cm with >50% collapse = RAP 0 to 5 mm Hg; >1.7 cm with >50% collapse = RAP 6 to 10 mm Hg; <50% collapse = RAP 10 to 15 mm Hg; and >1.7 cm with 0% collapse = RAP >15 mm Hg (51). (B) The tricuspid regurgitant velocity (TR Vel) is used to estimate the systolic right ventricle—right atrium gradient (and the pulmonary artery systolic pressure, in the absence of pulmonic stenosis). (C) The maximal pulmonic valve regurgitant velocity is used to estimate the mean pulmonary artery pressure (PAPm). The end diastolic pulmonic regurgitant velocity is used to estimate diastolic pulmonary artery pressure (PAPd). (D) The early mitral inflow (E-wave)/early diastolic mitral valve annular motion (E’-wave) ratio <8 or >15 is calculated to assess PCWP <15 mm Hg or >15 mm Hg, respectively. E/E’ = ratio of early diastolic mitral inflow velocity to early diastolic velocity of the mitral valve annulus; IVCCI = inferior vena cava collapsibility index; PCWP = pulmonary capillary wedge pressure; PR Vel. = pulmonic valve regurgitant velocity; RVSP = right ventricular systolic pressure.
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