Diagnosis of Pulmonary Arterial Hypertension

Trow, Terence K.; McArdle, John R.

doi:10.1016/j.ccm.2006.11.001

Cited by 43 publications

(29 citation statements)

References 150 publications

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“…Hastalık ilerledikçe sağ atriyumda ve sağ ventrikülde genişleme görülebilir. Sağ ventrikül büyümesi lateral grafide retrosternal alanın sağ ventrikül ile doldurulması ile tanınabilir (29). Toraks grafisi ayrıca pulmoner hipertansiyon ile ilişkili olabilecek pulmoner venöz konjesyon (sol kalp hastalığına bağlı pulmoner venöz hipertansiyon, pulmoner venooklüzif hastalık, pulmoner kapiller hemanjiyom), akciğerlerin aşırı havalanmasına neden olan kronik obstrüktif akciğer hastalığı ya da restriktif solunum sorunlarına yol açabilecek kifoskolyoz gibi diğer durumların tanınmasında da yararlıdır.…”

Section: ) Akciğer Grafisiunclassified

Echocardiography and other imaging modalities in pulmonary arterial hypertension

Özben

Başaran²

2010

Anadolu Kardiyol Derg

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It is essential to diagnose pulmonary arterial hypertension in early stages of the disease. However, most patients have late diagnosis due to the lack of disease-specific symptoms and prominent findings. Although cardiac catheterization is the gold standard in the diagnosis of pulmonary arterial hypertension, noninvasive diagnostic modalities do also have major roles in the diagnosis, risk assessment and follow-up of the patients with pulmonary arterial hypertension. The focus of the present review is the clinical role of echocardiography and other imaging modalities in pulmonary arterial hypertension. ÖZETPrognozu oldukça kötü olan pulmoner arteriyel hipertansiyonda tanının hastalığın erken dönemlerinde konulması oldukça önemlidir. Ancak semptomların spesifik olmaması ve hastalık bulgularının silik olması nedeniyle, birçok hastada tanıyı koymada geç kalınmaktadır. Tanıda altın standart olarak kardiyak kateterizasyon kabul edilse de, pulmoner arteriyel hipertansiyon tanı, risk değerlendirmesi ve tedavi takibinde noninvazif tanı yöntemlerinin yeri büyüktür. Bu derlemenin konusu pulmoner arteriyel hipertansiyon tanısında kullanılan ekokardiyografi ve diğer görüntüleme yöntemleridir.

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Section: ) Akciğer Grafisiunclassified

Echocardiography and other imaging modalities in pulmonary arterial hypertension

Özben

Başaran²

2010

Anadolu Kardiyol Derg

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“…Inclusion criteria were a prebronchodilator FEV 1 <65% of predicted and FEV 1 to FVC ratio <70%, baseline room air arterial oxygen tension between 60 and 75 mm Hg, PH documented by echocardiography demonstrating an estimated right ventricular systolic pressure (RVSP) greater than 35 mm Hg plus findings of right ventricle (RV) morphologic changes, and the ability to provide informed consent. The presence of RV dilation and/or hypertrophy on echocardiography was a necessary inclusion criteria for study subjects given the known limitations associated with echocardiography in the diagnosis of PH [15]. Exclusion criteria included clinical instability as evidenced by an acute exacerbation requiring an intensification of therapy and/or the need for hospitalization within the preceding 3 months, presence of an additional cause of lung disease as suggested by history, clinical, radiographic findings or pulmonary function tests, presence of left ventricular dysfunction and/or left atrial enlargement by echocardiography or catheterization, and heparin allergy.…”

Section: Methodsmentioning

confidence: 99%

Iloprost Improves Gas Exchange and Exercise Tolerance in Patients with Pulmonary Hypertension and Chronic Obstructive Pulmonary Disease

Dernaika

Beavin

Kinasewitz³

2009

Respiration

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Background: Nonselective systemic vasodilators worsen ventilation perfusion (V/Q) matching and gas exchange in patients with chronic obstructive pulmonary disease (COPD). Inhaled iloprost has the potential to act preferentially in ventilated regions of the lung, thereby reducing pulmonary hypertension (PH) while alveolar ventilation is still maintained. Objectives: To investigate the acute effects of inhaled iloprost on V/Q matching in patients with COPD and PH. Methods: Ten males with COPD and PH on echocardiography were evaluated before and after inhaling 2 doses of iloprost (2.5 µg). Measurements included lung function, arterial blood gas, 6-min walk test (6MWT) as well as ventilatory equivalents for oxygen (V_E/VO₂) and carbon dioxide (V_E/VCO₂) taken at baseline, 30 min following each dose of iloprost, and 2 h after the second dose. Results: Mean differences in V_E/VCO₂ and V_E/VO₂ were –13.3 (95% CI –36.5 to –2.7; p = 0.002) and –15.0 (95% CI –36.7 to –0.4; p = 0.02), respectively, and the mean change in (A-a) gradient was –3.7 mm Hg (95% CI –6.1 to –1.0; p = 0.01) after a single dose of iloprost, whereas mean improvement in 6MWT was 49.8 m (95% CI 14.8 to 84.7; p = 0.02). Arterial blood gas, venous admixture, dead space fraction and lung functions were maintained after iloprost. The effects of iloprost were reproducible after the second dose. All measurements returned to baseline 2 h after the last dose. No adverse effects on systemic blood pressure or oxygen saturation were seen. Conclusions: Iloprost inhalation was safe in patients with COPD and PH, and was associated with improved V/Q matching and exercise tolerance.

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“…Suspicion including symptoms and conditions which are associated with a risk for developing pulmonary hypertension. Early detection of pulmonary hypertension is vital for appropriate treatment [20]- [22]. Classification with a systematic approach to determine its cause to rule out the more common clinical groups of pulmonary hypertension such as left-sided heart disease, lung disease, and chronic thromboembolic pulmonary hypertension (CTEPH).…”

Section: Resultsmentioning

confidence: 99%

Findings Associated with Pulmonary Hypertension: CT Angiography Based Study

Aloub¹,

Ayad²,

Elnabi³

2016

OJRad

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Pulmonary hypertension (PH) is a complex disorder and may be related to a variety of diseases. It may arise in association with chronic thromboembolic pulmonary hypertension (CTEPH) or pulmonary embolism (PE). Knowledge of the radiological features is required to characterize and accurately diagnose the conditions and may improve the outcome. This study was designed to evaluate the clinical characteristics and the computerized tomography angiography findings in patients with PH, PE and CTEPH. Contrast-enhanced CT scans were acquired in 55 Sudanese patients with PE, 20 patients with PH, 25 patients with CTEPH and 50 normal subjects who were considered as control group. The CT diagnostic criteria for all cases were characterized. The clinical signs, parenchymal abnormalities, pulmonary tree and cardiac segments in all groups were characterized and compared with the control group. The results showed that the most common clinical characteristics were found to be chest pain, dyspnea, lower limb swelling, tachycardia and syncope which were correlated significantly with the presence of the disease. In all patients groups, the pulmonary vascular segments, cardiac segments and lung parenchyma changes were detected and were significantly different from the normal control subjects at p ≤ 0.01. It was found that CT angiography has a significant role in the diagnostic evaluation of these groups of patients. CT imaging is acceptably used in diagnosis, defining cause, quantifying heart segments and parenchyma changes in order to assess the feasibility of surgery, monitoring and therapeutic planning.

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Diagnosis of Pulmonary Arterial Hypertension

Cited by 43 publications

References 150 publications

Echocardiography and other imaging modalities in pulmonary arterial hypertension

Echocardiography and other imaging modalities in pulmonary arterial hypertension

Iloprost Improves Gas Exchange and Exercise Tolerance in Patients with Pulmonary Hypertension and Chronic Obstructive Pulmonary Disease

Findings Associated with Pulmonary Hypertension: CT Angiography Based Study

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