Table 6.
Sources of sPAP Overestimation or Underestimation Leading Correspondingly to Overdiagnosis or Underdiagnosis of Pulmonary Hypertension
| Overestimation n=99 | Underestimation n=159 | |
|---|---|---|
| CW Doppler, n (%) | ||
| Incomplete spectral wave envelope | 16 (16.2) | 110 (69.6) |
| Maximal velocity boundary artifacts (“fringes”) | 33 (33.3) | 2 (1.3) |
| Spectral gain set too soft | 12 (12.1) | 1 (0.6) |
| Velocity range set too high | 7 (7.1) | 1 (0.6) |
| Sweep velocity set to slow | 3 (3.0) | 1 (0.6) |
| Valve closure artifacts (“snaps”) | 2 (2.0) | 2 (1.3) |
| Atrial fibrillation | 7 (7.1) | 3 (1.9) |
| Severe tricuspid regurgitation | 1 (1.0) | 11 (7.0) |
| Inferior vena cava, n (%) | ||
| Respiration dynamics misinterpreted | 9 (9.1) | 20 (12.6) |
| Could not be depicted | 8 (8.1) | 7 (4.4) |
| Aorta mistaken as inferior vena cava | 1 (1.0) | 0 (0) |
Overestimation was defined when sPAP assessed with Doppler echocardiography was >35 mm Hg and mPAP measured invasively was <25 mm Hg, whereas underestimation was defined when sPAP assessed with Doppler echocardiography was ≤35 mm Hg and mPAP measured invasively was ≥25 mm Hg. CW indicates continuous‐wave Doppler; mPAP, pulmonary artery mean pressure; sPAP, systolic pulmonary artery pressure.