POOR AGREEMENT BETWEEN TRANSTHORACIC ECHOCARDIOGRAPHY AND RIGHT HEART CATHETERIZATION FOR ASSESSMENT OF PULMONARY HYPERTENSION SEVERITY: CLINICAL APPLICATIONS IN THE TAVR ERA

Various parameters reflecting right heart size, right ventricular function and capacitance have been shown to be prognostically important in patients with pulmonary hypertension (PH). In the advanced disease, patients suffer from right heart failure, which is a main reason for an impaired prognosis. Right heart size has shown to be associated with right ventricular function and reserve and is correlated with prognosis in patients with PH. Right ventricular reserve, defined as the ability of the ventricle to adjust to exercise or pharmacologic stress, is expressed by various parameters, which may be determined invasively by right heart catheterization or by stress-Doppler-echocardiography as a noninvasive approach. As the term “right ventricular contractile reserve” may be misleading, “right ventricular output reserve” seems desirable as a preferred term of increase in cardiac output during exercise. Both right heart size and right ventricular reserve have been shown to be of prognostic importance and may therefore be useful for risk assessment in patients with pulmonary hypertension. In this article we aim to display different aspects of right heart size and right ventricular reserve and their prognostic role in PH.

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Lodenafil treatment in the monocrotaline model of pulmonary hypertension in rats

Jornal Brasileiro de Pneumologia ◽

10.1590/s1806-37132014000400010 ◽

2014 ◽

Vol 40 (4) ◽

pp. 421-424 ◽

Cited By ~ 8

Author(s):

Igor Bastos Polonio ◽

Milena Marques Pagliareli Acencio ◽

Rogério Pazetti ◽

Francine Maria de Almeida ◽

Bárbara Soares da Silva ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Experimental Model ◽

Ventricular Hypertrophy ◽

Right Heart Catheterization ◽

Heart Catheterization ◽

Sprague Dawley ◽

Control Groups ◽

Right Heart ◽

Sprague Dawley Rats ◽

And Control

We assessed the effects of lodenafil on hemodynamics and inflammation in the rat model of monocrotaline-induced pulmonary hypertension (PH). Thirty male Sprague-Dawley rats were randomly divided into three groups: control; monocrotaline (experimental model); and lodenafil (experimental model followed by lodenafil treatment, p.o., 5 mg/kg daily for 28 days) Mean pulmonary artery pressure (mPAP) was obtained by right heart catheterization. We investigated right ventricular hypertrophy (RVH) and IL-1 levels in lung fragments. The number of cases of RVH was significantly higher in the monocrotaline group than in the lodenafil and control groups, as were mPAP and IL-1 levels. We conclude that lodenafil can prevent monocrotaline-induced PH, RVH, and inflammation.

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Methods to improve the yield of right heart catheterization in pulmonary hypertension

Respiratory Medicine X ◽

10.1016/j.yrmex.2020.100015 ◽

2020 ◽

Vol 2 ◽

pp. 100015

Author(s):

Ambalavanan Arunachalam ◽

Neal F. Chaisson ◽

Adriano R. Tonelli

Keyword(s):

Pulmonary Hypertension ◽

Right Heart Catheterization ◽

Heart Catheterization ◽

Right Heart

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Hepatic Venous Duplex as an Alternative Non- invasive Diagnostic Tool for Diagnosis of Pulmonary Hypertension

University Heart Journal ◽

10.3329/uhj.v16i2.49665 ◽

2020 ◽

Vol 16 (2) ◽

pp. 86-91

Author(s):

Md Harisul Hoque ◽

SM Mustafa Zaman ◽

Khurshid Ahmed ◽

Sajal Krisna Banerjee ◽

Md Faisal Ibne Kabir ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Diagnostic Tool ◽

Right Heart Catheterization ◽

Diagnostic Methods ◽

Heart Catheterization ◽

Right Heart ◽

Non Invasive ◽

Close Proximity ◽

The Right ◽

Practical Demonstration

Pulmonary hypertension is a hemodynamic disorder defined by abnormally high pulmonary artery pressure that affects the arteries in your lungs and the right side of your heart. In this study, hepatic venous duplex will be done to diagnose and quantify the PH. So that Patients can avoid unnecessary invasive right heart catheterization. This practical demonstration is the key to enrich our experience and knowledge in the field of PH. Objectives of this study was to assess PH status by Hepatic venous Duplex (HVD) as well by right heart catheterization and to compare them. This study was conducted in the Department of Cardiology, BSMMU, Shahbagh, Dhaka extending from July 2018 to December 2019. Total 100 (One hundred) subjects were enrolled in this study. It was an Observational study and includes the subjects between 18 years to 45 years of age. Results of this study shows very close proximity to that of Right heart catheterization. Hemodynamic changes in Hepatic venous duplex study could be used as an alternative diagnostic tool for evaluating moderate to severe pulmonary hypertension. This method could counteract the weakness of the currently used diagnostic methods and improve the accuracy of assessing pulmonary hypertension when combined with other methods. University Heart Journal Vol. 16, No. 2, Jul 2020; 86-91

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Effect of abnormal right heart structures on the diagnosis of pulmonary hypertension

Pulmonary Circulation ◽

10.1177/2045894018773053 ◽

2018 ◽

Vol 8 (2) ◽

pp. 204589401877305 ◽

Cited By ~ 1

Author(s):

Batool AbuHalimeh ◽

Milind Y. Desai ◽

Adriano R. Tonelli

Keyword(s):

Pulmonary Hypertension ◽

Pulmonary Artery ◽

Right Heart Catheterization ◽

The Other ◽

Heart Catheterization ◽

Right Heart ◽

Cardiac Lesions ◽

The Right ◽

The Impact ◽

Heart Lesions

The diagnosis of pulmonary hypertension (PH) requires a right heart catheterization (RHC) that reveals a mean pulmonary artery pressure ≥ 25 mmHg. The pulmonary artery catheter traverse the right atrium and ventricle on its way to the pulmonary artery. The presence of abnormal right heart structures, i.e. thrombus, vegetation, benign or malignant cardiac lesions, can lead to complications during this procedure. On the other hand, avoidance of RHC delays the diagnosis and treatment of PH, an approach that might be associated with worse outcomes. This paper discusses the impact of right heart lesions on the diagnosis of PH and suggests an approach on how to manage this association.

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Diagnosis of pulmonary hypertension associated whith systemic sclerosis

International Professional Journal Medicine ◽

10.31082/1728-452x-2020-215-216-5-6-15-23 ◽

2020 ◽

Vol 5-6 (215-216) ◽

pp. 15-23

Author(s):

Nazym Junusbayeva ◽

◽

Bakytsholpan Issayeva ◽

Keyword(s):

Pulmonary Hypertension ◽

Systemic Sclerosis ◽

Clinical Symptoms ◽

Survival Rates ◽

Early Death ◽

Daily Practice ◽

Right Heart Catheterization ◽

Heart Catheterization ◽

Right Heart ◽

The Right

Systemic sclerosis is the most common autoimmune disease associated with pulmonary hypertension. Pulmonary hypertension is a potential predictor of early death, and therefore, recently, interest in a comprehensive study of the diagnosis of pulmonary hypertension associated with systemic sclerosis has been increasing among researchers. Aim. Consideration of current diagnostic issues, as well as the principles of using diagnostic algorithms to verify pulmonary hypertension associated with systemic sclerosis, applied in daily clinical practice. Material and methods. In order to study the literature data, a search was carried out for information on this problem up to 10 years in depth in the Web of Science, PubMed/MEDLINE. During the search, the following terms were used individually and in combination: "systemic sclerosis", "pulmonary hypertension", "DETECT algorithm", "catheterization of the right heart chambers". The main search criteria were studies based on the study of patients with pulmonary hypertension associated with systemic sclerosis: meta-analyzes, original studies, retrospective and cohort studies. Results and discussion. The clinical symptoms of pulmonary hypertension can be nonspecific, which greatly complicates the diagnosis of the disease in the early stages. The absence of a specific clinical picture before the development of an advanced stage of pulmonary hypertension leads to late verification of the diagnosis. Key algorithms used in the daily practice of a doctor make it possible to minimize the number of undiagnosed cases of pulmonary hypertension. Conclusions. Diagnosis of PH associated with systemic sclerosis is often challenging for clinicians to practice. Early diagnosis and therefore treatment of PH are of paramount importance as they improve survival rates in patients with systemic sclerosis. Keywords: systemic sclerosis, pulmonary hypertension, screening, DETECT algorithm, right heart catheterization.

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Diagnosis and clinical investigation of patients presenting with pulmonary hypertension

ESC CardioMed ◽

10.1093/med/9780198784906.003.0584 ◽

2018 ◽

pp. 2507-2511 ◽

Cited By ~ 1

Author(s):

Daniela Calderaro ◽

Luis Felipe Prada ◽

Rogério Souza

Keyword(s):

Pulmonary Hypertension ◽

Clinical Investigation ◽

Right Heart Catheterization ◽

Heart Catheterization ◽

Right Heart ◽

Reference Centre ◽

Mean Pulmonary Arterial Pressure ◽

Invasive Test ◽

Pulmonary Arterial

The diagnosis of pulmonary hypertension (PH) relies on the haemodynamic criterion of mean pulmonary arterial pressure greater than or equal to 25 mmHg, assessed by right heart catheterization. The scope of this chapter is to discuss the key elements of clinical assessment of PH patients and the decision process to indicate right heart catheterization. Investigation must get through all the possible causes of PH according to their probability and frequency in the population. Echocardiography is the most important non-invasive test as an indicator for further diagnostic evaluation. Patients who are eligible for right heart catheterization should always be referred to PH centres, where technical skills and standardized procedures will enable maximal reliability of haemodynamic measurement. In the reference centre, a multidisciplinary team will discuss clinical and haemodynamic data, to propose the best therapeutic and follow-up schedule.

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CORRELATION BETWEEN RIGHT HEART CATHETERIZATION PRESSURES AND CLINICAL OUTCOMES IN PULMONARY HYPERTENSION

CHEST Journal ◽

10.1016/j.chest.2020.08.1425 ◽

2020 ◽

Vol 158 (4) ◽

pp. A1584

Author(s):

Keerthi Yarlagadda ◽

Selin Sendil ◽

Sahar Tahir ◽

Panupong Hansrivijit ◽

Vinod Nookala ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Clinical Outcomes ◽

Right Heart Catheterization ◽

Heart Catheterization ◽

Right Heart

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Right heart catheterization for pulmonary hypertension during the coronavirus disease 2019 pandemic

Pulmonary Circulation ◽

10.1177/2045894020948783 ◽

2020 ◽

Vol 10 (3) ◽

pp. 204589402094878 ◽

Cited By ~ 1

Author(s):

Kanza N. Qaiser ◽

James E Lane ◽

Adriano R. Tonelli

Keyword(s):

Pulmonary Hypertension ◽

Right Heart Catheterization ◽

Heart Catheterization ◽

Clinical Practices ◽

Right Heart ◽

Diagnostic Modality ◽

Hypertension Therapy ◽

Pulmonary Arterial ◽

Pulmonary Arterial Hypertension Therapy

Right heart catheterization is an essential diagnostic modality in the evaluation of pulmonary hypertension. The coronavirus disease 2019 pandemic has resulted in deferral of elective procedures including right heart catheterization. The benefits of proceeding with right heart catheterization, such as further characterization of hemodynamic subtype and severity of pulmonary hypertension, initiation of targeted pulmonary arterial hypertension therapy, as well as further hemodynamic testing, need to be carefully balanced with the risk of potentially exposing both patients and health care personnel to coronavirus disease 2019 infection. This review article aims to provide best clinical practices for safely performing right heart catheterization in pulmonary hypertension patients during the coronavirus disease 2019 pandemic.

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