More on the noninvasive diagnosis of pulmonary hypertension: Doppler echocardiography revisited

Naeije, Robert; Torbicki, Adam

doi:10.1183/09031936.95.08091445

Cited by 134 publications

(6 citation statements)

References 26 publications

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“…Disease severity and the effects of treatment in patients with PAH can be assessed noninvasively by measuring exercise capacity (6,7). However, echocardiographic and Doppler evaluation of these subjects is also useful, not only for diagnostic purposes but also to assess the magnitude of the pathophysiologic adaptations of the heart and pulmonary circulation (8,9). In addition, echocardiography is effective in detecting changes in cardiac structure and function associated with medical and surgical treatments (10 -16).…”

mentioning

confidence: 99%

Effects of the oral endothelin-receptorantagonist bosentan on echocardiographicand doppler measures in patients with pulmonary arterial hypertension

Galiè

Hinderliter

Torbicki³

et al. 2003

Journal of the American College of Cardiology

322

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mentioning

confidence: 99%

Effects of the oral endothelin-receptorantagonist bosentan on echocardiographicand doppler measures in patients with pulmonary arterial hypertension

Galiè

Hinderliter

Torbicki³

et al. 2003

Journal of the American College of Cardiology

322

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“…Doppler echocardiography is the non-invasive method of choice for the diagnosis of PAH [ 9 , 10 ], which can estimate the systolic and diastolic pulmonary artery pressures by measuring the maximum velocity of the tricuspid and pulmonary valve regurgitation using continuous wave Doppler echocardiography respectively, as well as allow an assessment of cardiac structure and function. The 2022 European Society of Cardiology (ESC) and European Respiratory Society (ERS) guidelines recommended echocardiography as the first-line, non-invasive diagnostic test for PAH.…”

Section: Discussionmentioning

confidence: 99%

Navigating Diagnostic Challenges: Severe Pulmonary Hypertension in Acute Exacerbation of Chronic Obstructive Pulmonary Disease vs. Pulmonary Embolism

Abdulfattah,

John

2024

Cureus

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A 63-year-old male with an unremarkable medical history presented to the emergency room (ER) with shortness of breath and bilateral lower extremity edema. In the ER, he was found to be hypoxic and hypercapnic on an arterial blood gas. CT angiography of the chest revealed severe emphysematous changes and large right apical bullae. A bedside point-of-care ultrasound demonstrated many bilateral B-lines as well as normal ejection fraction (EF). An echocardiogram revealed a small left ventricular cavity with an EF of 65%, severely dilated right ventricle, severe right ventricular dysfunction, "D" shaped interventricular septum, severely dilated right atrium, and severe pulmonary arterial hypertension (PAH) with a calculated pulmonary artery systolic pressure of 72 mmHg. The patient was initiated on bilevel positive airway pressure, glucocorticoids, bronchodilator nebulization, and diuretics with symptomatic improvement. Herein, this case report discusses similarities and differences between presentations and echocardiographic manifestations of severe PAH in the setting of acute exacerbation of chronic obstructive pulmonary disease and pulmonary embolism in the acute setting.

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“…Echocardiography presents technical difficulties in these patients because the overinflated chest may alter sound wave transmission. Even if a tricuspid regurgitation jet is observed, 44 echocardiographic estimates of PAP are often inaccurate and result in both false positive and false negative diagnosis of PH. Compared with right heart catheter measurements, estimations of systolic PAP by echocardiography were found to be inaccurate in 52% cases with COPD with a tendency to overestimate PAP.…”

Section: Evaluation and Diagnosismentioning

confidence: 99%

Management of Pulmonary Hypertension Associated with Chronic Lung Disease

Blanco

Hernández-González

García

et al. 2023

Semin Respir Crit Care Med

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Pulmonary hypertension (PH) is a common complication of chronic lung diseases, particularly in chronic obstructive pulmonary disease (COPD) and interstitial lung diseases (ILD) and especially in advanced disease. It is associated with greater mortality and worse clinical course. Given the high prevalence of some respiratory disorders and because lung parenchymal abnormalities might be present in other PH groups, the appropriate diagnosis of PH associated with respiratory disease represents a clinical challenge. Patients with chronic lung disease presenting symptoms that exceed those expected by the pulmonary disease should be further evaluated by echocardiography. Confirmatory right heart catheterization is indicated in candidates to surgical treatments, suspected severe PH potentially amenable with targeted therapy, and, in general, in those conditions where the result of the hemodynamic assessment will determine treatment options. The treatment of choice for these patients who are hypoxemic is long-term oxygen therapy and pulmonary rehabilitation to improve symptoms. Lung transplant is the only curative therapy and can be considered in appropriate cases. Conventional vasodilators or drugs approved for pulmonary arterial hypertension (PAH) are not recommended in patients with mild-to-moderate PH because they may impair gas exchange and their lack of efficacy shown in randomized controlled trials. Patients with severe PH (as defined by pulmonary vascular resistance >5 Wood units) should be referred to a center with expertise in PH and lung diseases and ideally included in randomized controlled trials. Targeted PAH therapy might be considered in this subset of patients, with careful monitoring of gas exchange. In patients with ILD, inhaled treprostinil has been shown to improve functional ability and to delay clinical worsening.

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More on the noninvasive diagnosis of pulmonary hypertension: Doppler echocardiography revisited

Cited by 134 publications

References 26 publications

Effects of the oral endothelin-receptorantagonist bosentan on echocardiographicand doppler measures in patients with pulmonary arterial hypertension

Effects of the oral endothelin-receptorantagonist bosentan on echocardiographicand doppler measures in patients with pulmonary arterial hypertension

Navigating Diagnostic Challenges: Severe Pulmonary Hypertension in Acute Exacerbation of Chronic Obstructive Pulmonary Disease vs. Pulmonary Embolism

Management of Pulmonary Hypertension Associated with Chronic Lung Disease

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