Right heart catheterization for hemodynamic evaluation of pulmonary hypertension

Abstract

Ключевые слова: легочная гипертензия, катетеризация правых отделов сердца, тест 6-минутной ходьбы. Objective description of clinical characteristics of patients, their physiological and hemodynamic parameters during right heart catheterization in the center of pulmonary hypertension in Ukraine. Material and methods. The procedure fof the right heart catheterization according to national and international protocols was performed in 108 patients with intermediate or high probability of pulmonary hypertension according to expert echocardiography. Physiological evaluation at the time of diagnosis includes a 6-minute walk test, a NTpro-BNP level, and an expert echocardiography with expanded protocol and an assessment of the right ventricular function. Results. We confirmed the presence of pulmonary hypertension in 94 patients (90.4%). During the diagnosis, 67% of patients with pulmonary hypertension had functional class III and 8%-functional class IV, 75% of patients had functional class III or IV. 67 patients underwent right heart catheterization before administering specific therapy for pulmonary hypertension, and the remaining 27 patients had already received specific therapy without confirmation of diagnosis. Our experience has shown that the lack of accurate hemodynamic measurements leads to a misleading diagnosis or inappropriate use of drugs specific to pulmonary hypertension, which can lead the patient to seek alternative treatments that have no proven efficacy. Conclusions. Catheterization of the right heart is the only way to reliable diagnosis of pulmonary hypertension and the risk of serious complications. It is necessary for the diagnosis of pulmonary hypertension, assessment of pulmonary hemodynamic condition and estimation of further prognosis.