Comparative Analysis of Transthoracic Echocardiographic and Invasive Hemodynamic Assessment of Pulmonary Artery Pressures in Acute Pulmonary Embolism Patients Undergoing Thrombectomy

Abstract Purpose: Transthoracic echocardiography (TTE)-derived pulmonary artery systolic pressure (PASP) is often used to estimate right ventricular (RV) afterload in acute pulmonary embolism (PE), yet its agreement with invasive measures during catheter-directed thrombectomy (CDT) remains unclear.

Methods

We retrospectively analyzed adults with acute PE who underwent CDT and had a TTE at least 48 hours before CDT. PASP was compared with invasively measured mean pulmonary artery pressure (mPAP) and peak pulmonary artery pressure (pPAP). Agreement was assessed using Bland–Altman analysis, intraclass correlation coefficient (ICC), Pearson correlation coefficient (r) and weighted κ. Sub-analyses were performed for studies ≤ 12 hours and ≤ 24 hours apart, as well as PAP pressure ranges < 30 mmHg, 30–44 mmHg, 45–59 mmHg and ≥60 mmHg.