Screening pulmonary hypertension by lung doppler signal: A proof-of-concept study
2015
Background: Transthoracic echocardiography is currently the best screening test for pulmonary hypertension (PH). However, it is associated with poor accuracy and significant rates of false positive or false negative results. Lung Doppler signals (LDS) that represent some characteristics of the mechanic properties of lung blood vessels have recently been described. We aimed to investigate the ability of LDS to detect PH in a population of patients suspected of PH and referred for right heart catheterization (RHC). Methods: 79 PH patients and 79 healthy controls matching for age, gender and BMI were recruited in a prospective case-control multicenter study. LDS recordings were performed by transthoracic parametric Doppler (TPD - EchoSense, Israel) consisting of a pulsed Doppler with a 2MHz single element transducer (diameter 16mm, focal length 5 cm). LDS were recorded within 24 hours of RHC. Following LDS feature extraction, classification and performance evaluation were made using a support vector machine (k-fold cross validation method). Results: The best LDS parameters for PH detection were the peak velocity and the rise slope of the systolic signal. The sensitivity and specificity of LDS in detecting PH in comparison of controls were: 82.7% (95%CI: 81.3-84.1) and 87.4% (95%CI: 86.3-88.5), respectively. The area under the receiver operating curve (ROC) curve was 0.95 (95%CI: 0.94-0.96) for diagnosis performance of LDS for PH detection. Ability of LDS to detect PH increased progressively with the level of mean pulmonary artery pressure. Conclusion: LDS recorded by the TPD have relatively good sensitivity and specificity to detect PH. Further studies are required to confirm the clinical usefulness of LDS.
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