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

Introduction: Patients with heart failure develop an increase in pulmonary pressure because of a retrograde mechanism. 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 the waiting list. Methods: Data from 90 patients of the UFMG Clinical Hospital was collected between 2004 and 2009. All the patients took an echo and catheterization as an integral part of pre-heart transplant. The mean age of the patients was 45.5 years, and 68 (75.6%) were male. Forty-two (46.7%) presented with Chagas’ disease, 32 (35.6%) presented idiopathic dilated cardiomyopathy, and 10 (11.1%) had ischemic cardiomyopathy. Results: The mean eco-PASP was 45 (±12mmHg). The mean cat-PASP was 47 (±14mmHg). 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 catPASP in Chagas’ patients was r=0.45; P=0.008 and in the non-Chagas was r = 0.66; P 32.5 mmHg have 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 have 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 ecoPASP 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 the vasodilation test.