Modern Invasive Hemodynamic Assessment of Pulmonary Hypertension.

Details

Serval ID
serval:BIB_D4C271BE0163
Type
Article: article from journal or magazin.
Publication sub-type
Editorial
Collection
Publications
Institution
Title
Modern Invasive Hemodynamic Assessment of Pulmonary Hypertension.
Journal
Respiration; international review of thoracic diseases
Author(s)
Pagnamenta A., Lador F., Azzola A., Beghetti M.
ISSN
1423-0356 (Electronic)
ISSN-L
0025-7931
Publication state
Published
Issued date
2018
Peer-reviewed
Oui
Volume
95
Number
3
Pages
201-211
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
Since 1998 pulmonary hypertension has been clinically classified into five well-defined, distinct categories. A definitive diagnosis of pulmonary hypertension requires the invasive confirmation of an elevated mean pulmonary artery pressure of 25 mm Hg or above during a right heart catheterization. From a hemodynamic point of view, pulmonary hypertension is classified into precapillary and postcapillary pulmonary hypertension on the basis of a pulmonary artery wedge pressure threshold value of 15 mm Hg. Pulmonary vascular resistance is better characterized by multi-point pressure/flow measurements than by single-point determination. Multi-point pulmonary vascular resistance calculation could be useful for early disease identification as well as for treatment response assessment. Occlusion analysis of the pulmonary artery pressure decay curve after balloon inflation at the tip of the pulmonary artery catheter permits locating the site of predominantly increased resistance and could be useful in differentiating proximal from distal vasculopathy, especially in chronic thromboembolic pulmonary hypertension. The pulsatile hydraulic load of the pulmonary circulation can be better appreciated by pulmonary vascular impedance or via the resistance-compliance relationship than by means of pulmonary vascular resistance. Determination of right ventriculo-arterial coupling permits assessing the impact of an elevated afterload on right ventricular function, which ultimately determines the symptoms and prognosis of patients with pulmonary hypertension. The clinical utility of combining different invasive hemodynamic approaches is still uncertain and remains to be determined.
Keywords
Cardiac Catheterization, Hemodynamics, Humans, Hypertension, Pulmonary/diagnosis, Hypertension, Pulmonary/physiopathology, Ventricular Function, Right, Partitioning of pulmonary vascular resistance, Pulmonary vascular impedance, Pulmonary vascular resistance, Right heart catheterization, Right ventriculo-arterial coupling
Pubmed
Web of science
Create date
10/01/2019 18:29
Last modification date
11/10/2019 6:26
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