TY - JOUR
T1 - Non-Invasive Assessment of Pulmonary Vascular Resistance in Pulmonary Hypertension
T2 - Current Knowledge and Future Direction
AU - Naing, Pyi
AU - Kuppusamy, Harveen
AU - Scalia, Gregory
AU - Hillis, Graham S.
AU - Playford, David
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Pulmonary Hypertension (PHT) is relatively common, dangerous and under-recognised. Pulmonary hypertension is not a diagnosis in itself; it is caused by a number of differing diseases each with different treatments and prognoses. Therefore, timely and accurate recognition of the underlying cause for PHT is essential for appropriate management. This is especially true for patients with Pulmonary Arterial Hypertension (PAH) in the current era of disease-specific drug therapy.Measurement of Pulmonary Vascular Resistance (PVR) helps separate pre-capillary from post-capillary PHT, and is measured with right heart catheterisation (RHC). Echocardiography has been used to derive a number of non-invasive surrogates for PVR, with varying accuracy. Ultimately, the goal of non-invasive assessment of PVR is to separate PHT due to left heart disease from PHT due to increased PVR, to help streamline investigation and subsequent treatment. In this review, we summarise the physiology and pathophysiology of pulmonary blood flow, the various causes of pulmonary hypertension, and non-invasive surrogates for PVR.
AB - Pulmonary Hypertension (PHT) is relatively common, dangerous and under-recognised. Pulmonary hypertension is not a diagnosis in itself; it is caused by a number of differing diseases each with different treatments and prognoses. Therefore, timely and accurate recognition of the underlying cause for PHT is essential for appropriate management. This is especially true for patients with Pulmonary Arterial Hypertension (PAH) in the current era of disease-specific drug therapy.Measurement of Pulmonary Vascular Resistance (PVR) helps separate pre-capillary from post-capillary PHT, and is measured with right heart catheterisation (RHC). Echocardiography has been used to derive a number of non-invasive surrogates for PVR, with varying accuracy. Ultimately, the goal of non-invasive assessment of PVR is to separate PHT due to left heart disease from PHT due to increased PVR, to help streamline investigation and subsequent treatment. In this review, we summarise the physiology and pathophysiology of pulmonary blood flow, the various causes of pulmonary hypertension, and non-invasive surrogates for PVR.
KW - Pulmonary hypertension (PHT)
KW - Doppler echocardiography
KW - Pulmonary arterial hypertension
KW - Pulmonary vascular resistance (PVR)
KW - Heart failure with preserved ejection fraction (HFpEF)
KW - PRESERVED EJECTION FRACTION
KW - ARTERIAL-HYPERTENSION
KW - HEART-FAILURE
KW - DOPPLER-ECHOCARDIOGRAPHY
KW - PHOSPHODIESTERASE-5 INHIBITION
KW - FILLING PRESSURES
KW - BOSENTAN THERAPY
KW - DIAGNOSIS
KW - RATIO
KW - REGURGITATION
U2 - 10.1016/j.hlc.2016.10.008
DO - 10.1016/j.hlc.2016.10.008
M3 - Review article
C2 - 27939746
VL - 26
SP - 323
EP - 330
JO - Heart, Lung & Circulation
JF - Heart, Lung & Circulation
SN - 1444-2892
IS - 4
ER -