Performance of a Novel Echocardiographic Marker Against Right Heart Catheterisation in Identifying Pulmonary Hypertension due to Left Heart Disease

2017 ◽  
Vol 26 ◽  
pp. S269
Author(s):  
P. Naing ◽  
G. Scalia ◽  
G. Hillis ◽  
G. Strange ◽  
D. Playford
2015 ◽  
Vol 24 (138) ◽  
pp. 665-673 ◽  
Author(s):  
Harrison W. Farber ◽  
Simon Gibbs

Pulmonary hypertension (PH) associated with left heart disease (PH-LHD) is the most common type of PH, but its natural history is not well understood. PH-LHD is diagnosed by right heart catheterisation with a mean pulmonary arterial pressure ≥25 mmHg and a pulmonary capillary wedge pressure >15 mmHg. The primary causes of PH-LHD are left ventricular dysfunction of systolic and diastolic origin, and valvular disease. Prognosis is poor and survival rates are low. Limited progress has been made towards specific therapies for PH-LHD, and management focuses on addressing the underlying cause of the disease with supportive therapies, surgery and pharmacological treatments. Clinical trials of therapies for pulmonary arterial hypertension in patients with PH-LHD have thus far been limited and have provided disappointing or conflicting results. Robust, long-term clinical studies in appropriate target populations have the potential to improve the outlook for patients with PH-LHD. Herein, we discuss the knowledge gaps in our understanding of PH-LHD, and describe the current unmet needs and challenges that are faced by clinicians when identifying and managing patients with this disease.


2019 ◽  
Author(s):  
Lucia Kris Dinarti ◽  
Anggoro Budi Hartopo ◽  
Arditya Damar Kusuma ◽  
Muhammad Gahan Satwiko ◽  
Muhammad Reyhan Hadwiono ◽  
...  

Abstract Backgrounds: The COngenital HeARt Disease in adult and Pulmonary Hypertension (COHARD-PH) registry is the first congenital heart disease (CHD) and CHD-related pulmonary hypertension (PH) in adults registry in Indonesia. The study aims to describe prevalence, characteristics, and hemodynamic the demographics, clinical presentation, and hemodynamics data of adult CHD and CHD-related PH in Indonesia. Methods: The COHARD-PH registry is a hospital-based, single-center, and prospective registry which includes adult patients with CHD and CHD-related PH. The patients were enrolled consecutively. For this study, we evaluated the registry patients from July 2012 until July 2018 2019. The enrolled patients underwent clinical examination, electrocardiography, chest x-ray, 6 minute walking test, laboratory measurement, and transthoracic and transoesofageal echocardiography. Right heart catheterisation was performed to measure hemodynamics and confirmed the diagnosis of pulmonary artery hypertension (PAH). Results: We registered 803 1012 patients during the study. The majority were young-adult females. The majority of CHD was secundum ASD (79.0%) (73.4%). The main symptom was dyspneu on effort. The majority of patients (78.1%) (77.1%) had already developed signs of PH assessed by echocardiography. The Eisenmenger syndrome was encountered in 17.3% 18.7% patients. Based on the right heart catheterisation, 67.8% 66.9% patients had developed PAH. Patients with PAH were significantly older, had lower peripheral oxygen saturation, had lower 6 minute walking distance, and had higher NTproBNP. There was an increased of proportion of PAH prevalence according to age range, with the highest prevalence between 51 and 60 years old. Conclusions: The COHARD-PH registry is the first Indonesian adult-CHD and CHD-related PH registry. The prevalence, characteristics, and hemodynamics data demographics, clinical presentation, and hemodynamics data of this registry reflects situation in developing countries which need to be compared with similar registries from developed countries.


PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261753
Author(s):  
Yusuke Joki ◽  
Hakuoh Konishi ◽  
Hiroyuki Ebinuma ◽  
Kiyoshi Takasu ◽  
Tohru Minamino

Background Heart failure is a severe condition often involving pulmonary hypertension (PH). Soluble low-density lipoprotein receptor with 11 ligand-binding repeats (sLR11) has been associated with pulmonary artery hypertension. We examined whether sLR11 correlates with PH in left heart disease and can be used as a predictive marker. Method We retrospectively analyzed patients with severe mitral regurgitation who underwent right heart catheterization before surgery for valve replacement or valvuloplasty from November 2005 to October 2012 at Juntendo University. We measured sLR11 levels before right heart catheterization and analyzed correlations with pulmonary hemodynamics. We compared prognoses between a group with normal sLR11 (≤9.4 ng/ml) and a group with high sLR11 (>9.4 ng/ml). Follow-up was continued for 5 years, with end points of hospitalization due to HF and death due to cardiovascular disease. Results Among 34 patients who met the inclusion criteria, sLR11 correlated with mean pulmonary artery pressure (r = 0.54, p<0.001), transpulmonary pressure gradient (r = 0.42, p = 0.012), pulmonary vascular resistance (r = 0.36, p<0.05), and log brain natriuretic peptide (BNP). However, logBNP did not correlate with pulmonary vascular resistance (p = 0.6). Levels of sLR11 were significantly higher in the 10 patients with PH (14.4±4.3 ng/ml) than in patients without PH (9.9±3.9 ng/ml; p = 0.002). At 5 years, the event rate was higher in the high-sLR11 group than in the normal-sLR11 group. The high-sLR11 group showed 5 hospitalizations due to HF (25.0%) and 2 deaths (10.0%), whereas the normal-sLR11 group showed no hospitalizations or deaths. Analyses using receiver operating characteristic curves showed a higher area under the concentration-time curve (AUC) for sLR11 level (AUC = 0.85; 95% confidence interval (CI) = 0.72–0.98) than for BNP (AUC = 0.80, 95%CI = 0.62–0.99) in the diagnosis of PH in left heart disease. Conclusions Concentration of sLR11 is associated with severity of PH and offers a strong predictor of severe mitral regurgitation in patients after surgery.


2020 ◽  
Author(s):  
L. K. Pallos ◽  
J. M. Dietrich ◽  
A. Simon ◽  
E. Carls ◽  
M. Matthey ◽  
...  

2015 ◽  
Vol 14 (2) ◽  
pp. 105-110

Guest editor Teresa De Marco, MD, along with Brian Shapiro, MD, Mayo Clinic, Jacksonville, FL, convened a panel of experts to discuss the challenges in diagnosis and treatment and the emerging science regarding pulmonary hypertension due to left heart disease. Contributing to the engaging discussion were James Fang, MD, University of Utah School of Medicine; Barry Borlaug, MD, Mayo Clinic, Rochester, MN; and Srinivas Murali, MD, Allegheny Health Network, Pittsburgh, PA.


2018 ◽  
Vol 16 (6) ◽  
pp. 555-560 ◽  
Author(s):  
Ghazal Kabbach ◽  
Debabrata Mukherjee

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