Nicht-invasive Diagnostik der pulmonalen Hypertonie

Grünig, Ekkehard; Barner, Andreas; Bell, Murray F.; Claussen, Michael; Dandel, Michael; Dumitrescu, Daniel; Gorenflo, M.; Holt, Stephan; Kovács, György; Ley, S; Meyer, J.; Pabst, S; Riemekasten, Gabriela; Saur, Joachim; Schwaiblmair, Martin; Seck, Catherine; Sinn, Lutz; Sorichter, Stephan; Winkler, J; Leuchte, Hanno

doi:10.1055/s-0030-1263314

Cited by 7 publications

(4 citation statements)

References 8 publications

(9 reference statements)

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“…Non-smokers were additionally divided into passive smokers (defined as having been exposed to secondhand smoke for >1 h a day >1 year) and not exposed. Diagnosis of precapillary PH was made according to international criteria and guidelines by a thorough investigation, including right heart catheterization, computed tomography of the chest, a ventilation-perfusion scan, a pulmonary function test, blood gases, blood values and other exams as appropriate [1,9] . Inclusion criteria were pulmonary artery pressure ≥ 25 mm Hg and pulmonary artery wedge pressure ≤ 15 mm Hg.…”

Section: Methodsmentioning

confidence: 99%

Tobacco Smoke Exposure in Pulmonary Arterial and Thromboembolic Pulmonary Hypertension

Keusch¹,

Hildenbrand²,

Bollmann³

et al. 2014

Respiration

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BACKGROUND: Animal studies and data from a single-center study suggest that tobacco smoke exposure may be a risk factor for precapillary pulmonary hypertension (PH). OBJECTIVE: We aimed to survey tobacco smoke exposure in a large PH collective and to compare it with epidemiological data from healthy subjects. METHODS: This is an international, multicenter, case-control study including patients with pulmonary arterial and chronic thromboembolic PH. All patients were asked specific questions about tobacco smoke exposure. Healthy controls were retrieved from the Swiss Health Survey (n = 18,747). RESULTS: Overall (n = 472), 49% of PH patients were smokers and there was a clear sex difference (women 37%, men 71%). Significantly more PH men were smokers compared with healthy controls, whereas less PH women were ever active smokers. However, 50% of the non-smoking PH women were exposed to secondhand smoke, leading to a significantly higher number of tobacco smoke-exposed individuals compared to healthy controls. PH smokers were significantly younger compared to those not exposed. CONCLUSION: Active and environmental tobacco smoke exposure is common in PH. The higher prevalence of male PH smokers, the higher exposure to environmental tobacco smoke in PH women compared to healthy controls and the lower age at PH diagnosis in smokers may indicate a pathogenic role of tobacco smoke exposure in PH. were smokers compared with healthy controls, whereas less PH women were ever active smokers. However, 50% of the non-smoking PH women were exposed to secondhand smoke, leading to a significantly higher number of tobacco smoke-exposed individuals compared to healthy controls. PH smokers were significantly younger compared to those not exposed. Conclusion: Active and environmental tobacco smoke exposure is common in PH. The higher prevalence of male PH smokers, the higher exposure to environmental tobacco smoke in PH women compared to healthy controls and the lower age at PH diagnosis in smokers may indicate a pathogenic role of tobacco smoke exposure in PH.

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Section: Methodsmentioning

confidence: 99%

Tobacco Smoke Exposure in Pulmonary Arterial and Thromboembolic Pulmonary Hypertension

Keusch¹,

Hildenbrand²,

Bollmann³

et al. 2014

Respiration

View full text Add to dashboard Cite

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“…Echocardiography: Echocardiography is currently the non-invasive method with the highest sensitivity and specificity for diagnosing PH. Hypertrophic and dilated right ventricle, a flattened ventricular septum (possibly with paradoxical motion), a dilated right atrium, and a dilated inferior vena cava are typical signs of pulmonary hypertension [ 21 ]. Independent prognostic factors are an enlarged right atrium (RA surface >27 mm²), the presence of pericardial effusion, and impaired global pumping capacity of the right ventricle [ 21 ].…”

Section: Methodsmentioning

confidence: 99%

Perioperative management of patients with severe pulmonary hypertension in major orthopedic surgery: experience-based recommendations

Gille

Sablotzki

Gerlach

et al. 2015

GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW; 4:Doc03; ISSN 2193-8091

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“…Dabei ist zu beachten, dass die Sensitivität zur Erkennung einer frühen PH von den gewählten Grenzwerten der trikuspidalen Refluxgeschwindigkeit (TRV) abhängig ist. Bei Patienten (insbesondere bei Vorliegen einer anderweitig nicht erklärbaren Dyspnoe) erscheint bei einer TRV von 2,9 -3,4 m/s (entspricht etwa einem systolischen PAP von 37 -50 mmHg) das Vorliegen einer PH möglich und es sollte eine invasive Kontrolle erfolgen [42]. Auch bei Unterschreiten des Grenzwertes der TRV, aber vorhandenen anderen echokardiografischen Hinweisen auf eine PH oder bei Risikogruppen für die PH (z.…”

Section: These 3 !unclassified

Die frühe Diagnose und Therapie der pulmonalen Hypertonie - Aspekte einer Vision

et al. 2013

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In patients with pulmonary hypertension progressive vascular changes in the lung precede the clinical and hemodynamic manifestations of the disease. Therefore, early diagnosis and timely treatment of the disease are crucial. This has been the topic of an expert meeting in Greifswald, Germany in June 2012. The current definition of pulmonary hypertension requires a mean pulmonary artery pressure ≥ 25 mmHg at rest, a hemodynamic abnormality already reflecting pulmonary vascular changes beyond early disease. There is increasing evidence supporting the concept that a lower pressure threshold at rest or an abnormal pressure response with exercise better characterize early disease. While right heart catheterization at rest remains the diagnostic gold standard other methods for detecting early disease are explored with echocardiography being the most frequently used technique. Targeted therapy has been approved for patients with pulmonary arterial hypertension (PAH, WHO-group I) in functional class II-IV. Preliminary data in functional class I patients suggest therapeutic potential of theses drugs in early disease as well. Current guidelines propose therapeutic goals based on parameters with prognostic importance. However, these recommendations are based on mostly retrospective analyses of pre-treatment data obtained in patients with pulmonary hypertension in functional class II-IV. Therefore, evidence-based therapeutic goals for early interventions in functional class I patients are lacking.

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Nicht-invasive Diagnostik der pulmonalen Hypertonie

Cited by 7 publications

References 8 publications

Tobacco Smoke Exposure in Pulmonary Arterial and Thromboembolic Pulmonary Hypertension

Tobacco Smoke Exposure in Pulmonary Arterial and Thromboembolic Pulmonary Hypertension

Perioperative management of patients with severe pulmonary hypertension in major orthopedic surgery: experience-based recommendations

Die frühe Diagnose und Therapie der pulmonalen Hypertonie - Aspekte einer Vision

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