Imaging of pulmonary hypertension: an update

Abstract

Pulmonary hypertension (PH) is characterized by elevated pulmonary arterial pressure caused by a broad spectrum of congenital and acquired disease processes, which are currently divided into five groups based on the 2013 WHO classification. Imaging plays an important role in the evaluation and management of PH, including diagnosis, establishing etiology, quantification, prognostication and assessment of response to therapy. Multiple imaging modalities are available, including radiographs, computed tomography (CT), magnetic resonance imaging (MRI), nuclear medicine, echocardiography and invasive catheter angiography (ICA), each with their own advantages and disadvantages. In this article, we review the comprehensive role of imaging in the evaluation of PH.

Pulmonary hypertension secondary to pulmonary fibrosis: clinical data, histopathology and molecular insights

“…Cardiac magnetic resonance imaging (MRI) is a more advanced non-invasive cardiovascular imaging tool for evaluation of PH available at more specialized centers. In fact, this technology is considered the gold standard in the quantification of right ventricle volumes and function given the limitations of TTE in obtaining optimal acoustic windows in some patients [63,70]. With respect to PF patients with suspected PH, Chin et al found diastolic pulmonary arterial area as measured by magnetic resonance imaging was accurate for detection of PH (AUC 0.897) and correlated well with RHC-derived mPAP [66].…”

Assessment of Right Ventricular Function in Pulmonary Hypertension with Multimodality Imaging

“…Dilated RV and thickened RV wall are also suggestive of PH. RV dilation is diagnosed in axial images when RV:LV diameter is > 1, and RV hypertrophy is diagnosed when RV wall thickness is > 4 mm 60)…”

Hallazgos por ecocardiografía bidimensional en individuos con sospecha de hipertensión pulmonar. Experiencia de cinco años en el sureste de México

“…Con frecuencia los pacientes buscan atención médica en etapas avanzadas de la enfermedad cuando ya existe falla del ventrículo derecho (VD). 2,7,12,13 La mejor forma de realizar el tamizaje cuando se sospecha HP es mediante el ecocardiograma transtorácico (ECOTT) bidimensional con modo-M. [14][15][16] El ECOTT es una herramienta portátil, no invasiva, de relativo bajo costo, con mayor accesibilidad que el CCD y brinda múltiples parámetros confiables sobre la hemodinámica pulmonar. 17 Por ejemplo, Li et al documentaron una buena correlación entre la medición de PsAP por Eco y la PsAP medida por CCD (r = 0.794).…”