@article {Billetjrheum.180571, author = {Sophie Billet and Gr{\'e}gory Pugnet and Thomas Chollet and Ga{\'e}tan Charbonnier and Pauline Fournier and Gr{\'e}goire Pr{\'e}vot and Laurent Tetu and Maxime Cournot and H{\'e}l{\`e}ne Derumeaux and Didier Carri{\'e} and Michel Galinier and Olivier Lairez}, title = {The Use of Transthoracic Echocardiogram to Quantify Pulmonary Vascular Resistance in Patients with Systemic Sclerosis}, elocation-id = {jrheum.180571}, year = {2019}, doi = {10.3899/jrheum.180571}, publisher = {The Journal of Rheumatology}, abstract = {Objective To explore the accuracy of tricuspid regurgitation velocity (TRV) to right ventricular outflow tract time-velocity integral (TVIRVOT) ratio by Doppler to determine pulmonary vascular resistance (PVR) in patients with systemic sclerosis (SSc). Methods Thirty-five consecutive adult patients with SSc, fulfilling the 2013 European League Against Rheumatism/American College of Rheumatology classification criteria, with sinus rhythm referred for right heart catheterization (RHC), were retrospectively included. All patients underwent a transthoracic echocardiogram (TTE) performed within 24 h of RHC. Patients with SSc were recruited regardless of disease activity, cardiac symptoms, and treatment regimen. Doppler measurements were compared to RHC measurements. A linear regression equation was generated to predict PVR by echocardiogram based on the TRV/TVIRVOT ratio. The accuracy of Doppler measurements for predicting PVR \> 3 Wood units was assessed by computing the areas under the receiver-operating characteristic curves. Results There were 20 (57\%) females in the study. The mean age was 65 {\textpm} 12 years. Mean and systolic pulmonary arterial pressures were 31 {\textpm} 8 and 53 {\textpm} 15 mmHg, respectively. There was a good correlation between TRV/TVIRVOT ratio assessed by Doppler and PVR measured by RHC (R = 0.743, p \< 0.001). The equation generated by this analysis was the following: PVR by Doppler = 11.3 {\texttimes} (TRV/TVIRVOT) + 1.7. A cutoff value of 0.21 for TRV/TVIRVOT ratio provided the best sensitivity (86\%) and specificity (86\%) to determine PVR \> 3 Wood units. Conclusion Our study suggests that TTE using Doppler could be a useful and noninvasive tool for estimating PVR in patients with SSc.}, issn = {0315-162X}, URL = {https://www.jrheum.org/content/early/2019/05/13/jrheum.180571}, eprint = {https://www.jrheum.org/content/early/2019/05/13/jrheum.180571.full.pdf}, journal = {The Journal of Rheumatology} }