Pulmonary pressure checked by echocardiography in chagasic patients on the heart transplant waiting list.

Introduction: The patients suffering heart failure develop an increase in pulmonary pressure because of a retrograde mechanism. The pulmonary hypertension is a prognostic marker. Objective: The aim of this study is to correlate pulmonary hypertension measured by echocardiogram versus catheterization in pre-heart transplant patients on waiting list. Methods: Data from 90 patients of the Clinical Hospital UFMG were collected between 2004 and 2009. All the patients took an echo and catheterization as an integral part of pre-heart transplant. Mean age was 45.5 years old, 68 (75.6%) male. Foully-two (46.7%) were Chagas' disease patients, 32 (35.6%) presented idiopathic dilated cardiomyopathy, 10 (11.1%) had ischemic cardyomiopathy. Results: The mean eco-PASP was 45 +/- 12mmHg). The mean cat-PASP was 47 +/- 14mmlig. The eco-PASP-Chagas was 41.7 +/- 12,5 mmHg and non-Chagas 47.6 +/- 12.8 mmHg P=0.04. The cat-PASP-Chagas was 46 +/- 12.1 mmHg and non-Chagas 48.7 +/- 12.8 mmHg P=0.43. Eight patients had cat-PASP > 60. The correlation between eco-PASP and cat-PASP in Chagas' patients was r=0.45; P=0.008 and in the non-Chagas was r=0.66; P < 0.001. The eco-PASP-Chagas > 32,5mmHg has a sensitivity of 79% and specificity of 75% to diagnose PH, with an area under the curve of 0.819. The eco-PASP-non-Chagas > 35.5 mmHg has a sensitivity of 82% and a specificity of 70% to diagnose PH, with an area under the curve of 0.776. Conclusions: There is a good correlation between eco-PASP and cat-PASP(r=0.54) in pre-heart transplant patients. The eco-PASP was lower in the Chagas' group. The echocardiogram is an important method to diagnosis and control pulmonary pressure in pre-heart transplant, specifically in Chagas' patients. The catheterization is still important to evaluate pulmonary reactivity during vasodilation test.