Improving the echocardiographic assessment of pulmonary pressure using the tricuspid regurgitant signal- the "chin" vs the "beard"

Transthoracic echocardiography (TTE) is a fundamental investigation for the noninvasive assessment of pulmonary hemodynamics and right heart function. The aim of this study was to assess the correlation and agreement of Doppler calculation of right ventricular systolic pressure (RVSP) and pulmonary vascular resistance (PVR) using "chin" and "beard" measurements of tricuspid regurgitant velocity (TRV ), with invasive pulmonary artery systolic pressure (PASP) and PVR. One hundred patients undergoing right heart catheterisation (RHC) and near simultaneous transthoracic echocardiography were studied. TRV was recorded for "chin" measurement (distinct peak TRV signal) and where available (63 patients), "beard" measurement (higher indistinct peak TRV signal). Measurable TRV signal was obtained in 96 patients. Mean RVSP 54.7 ± 22.7 mm Hg and RVSP 68.6 = 23 ± 26.3 mm Hg (P The accuracy of noninvasive measurement of right heart pressures is increased using the "chin" in estimation of both RVSP and PVR.