Diagnostic and Predictive Value of Right Heart Catheterization-Derived Measurements in Pulmonary Hypertension

Abstract

Right heart catheterization is a unique tool not only in the diagnosis but also in the management of patients with a wide range of cardiovascular diseases. The technique dates back to the 18th century, but the biggest advances were made in the 20th century. This review focuses on pulmonary hypertension for which right heart catheterization remains the diagnostic gold standard. Right heart catheterization-derived parameters help classify pulmonary hypertension into several subgroups, assess risk of adverse events or mortality and make therapeutic decisions. According to the European Society of Cardiology guidelines pulmonary hypertension (PH) is defined as an increase in mean pulmonary artery pressure (PAPm) > 25 mmHg, whereas a distinction between pre- and post-capillary PH is made based on levels of pulmonary artery wedge pressure (PAWP). Moreover, right atrial pressure (RAP), cardiac index (CI) and mixed venous oxygen saturation (SvO2) are the only parameters recommended to assess prognosis and only in patients with pulmonary arterial hypertension (PAH). Patients with RAP > 14 mmHg, CI < 2.0 l/min/m2 and SvO2 < 60% are at high (> 10%) risk of death within the next year. The purpose of this paper is to show that RHC-derived parameters can be used on a considerably larger scale than currently recommended. Several prognostic parameters, with specific thresholds have been identified for each subtype of pulmonary hypertension and can be helpful in everyday practice for treatment of PH.

Pulmonary hypertension in dog: Case report

“…1,2 The right heart catheterization is the standard test in humans to diagnose pulmonary hypertension. 9 However, in veterinary medicine, this method is not widely used, due to the need sedation of the patient, which can worsen the clinical condition of the animal.…”

Management of pulmonary arterial hypertension：before, during and after pregnancy

“…Right Heart Catheter (RHC) is considered the diagnostic gold standard for PAH, the parameters of which help classify PAH into several subgroups, assess the risk of adverse events or mortality, and make therapeutic decisions [ 26 ]. However, since it is an invasive procedure with a risk of radiation to the fetus, it is not generally recommended during pregnancy.…”