Noninvasive Assessment of Pulmonary Hypertension: A Simultaneous Echo-Doppler Hemodynamic Study

Marangoni, S.; Quadri, A; Dotti, A.; Scalvini, Simonetta; Volterrani, Maurizio; Schena, Miriam; Foglio, K.; Errera, Donatella; Levi, Guido

doi:10.1159/000174410

Cited by 27 publications

(9 citation statements)

References 10 publications

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“…Also, Marangoni et al reported that there was an excellent correlation between the measurements of PAP by Doppler echocardiography and by invasive method. 16 In addition, invasive method in estimating PAP is a difficult and a traumatic procedure for the patients. Also, it was difficult to obtain the approval of patients, who were included in the study, for invasive procedure because of the above-mentioned reasons.…”

Section: Discussionmentioning

confidence: 99%

The long‐term effects of arteriovenous fistula creation on the development of pulmonary hypertension in hemodialysis patients

Ünal¹,

Taşdemir²,

Oymak

et al. 2010

Hemodialysis International

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The aim of this prospective study was to evaluate long-term effects of arteriovenous fistula (AVF) on the development of pulmonary arterial hypertension (PAH) and the relationship between blood flow rate of AVF and pulmonary artery pressure (PAP) in the patients with end-stage renal disease (ESRD). This prospective study was performed in 20 patients with ESRD. Before an AVF was surgically created for hemodialysis, the patients were evaluated by echocardiography. Then, an AVF was surgically created in all patients. After mean 23.50 ± 2.25 months, the second evaluation was performed by echocardiography. Also, the blood flow rate of AVF was measured at the second echocardiographic evaluation. Pulmonary arterial hypertension was defined as a systolic PAP above 35 mmHg at rest. Mean age of 20 patients with ESRD was 55.05 ± 13.64 years; 11 of 20 patients were males. Pulmonary arterial hypertension was detected in 6 (30%) patients before AVF creation and in 4 (20%) patients after AVF creation. Systolic PAP value was meaningfully lower after AVF creation than before AVF creation (29.95 ± 10.26 mmHg vs. 35.35 ± 7.86 mmHg, respectively, P: 0.047). However, there was no significant difference between 2 time periods in terms of presence of PAH (P>0.05). Pulmonary artery pressure did not correlate with blood flow rate of AVF and duration after AVF creation (P>0.05). In hemodialysis patients, a surgically created AVF has no significant effect on the development of PAH within a long-term period. Similarly, blood flow rate of AVF also did not affect remarkably systolic PAP within the long-term period.

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Section: Discussionmentioning

confidence: 99%

The long‐term effects of arteriovenous fistula creation on the development of pulmonary hypertension in hemodialysis patients

Ünal¹,

Taşdemir²,

Oymak

et al. 2010

Hemodialysis International

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“…Estimated RVSP was obtained using the modified Bernoulli equation and was recorded as a continuous variable; PH was defined as a RVSP ≥ 40 mmHg 3,10,24–26 . Sensitivity analyses were conducted in which PH was defined as a RVSP ≥ 36 mmHg and RVSP was treated as a continuous predictor of allograft failure 24 .…”

Section: Methodsmentioning

confidence: 99%

Echocardiographic Pulmonary Hypertension Predicts Post-transplantation Renal Allograft Failure

Foderaro

Baird

Bazargan-Lari

et al. 2017

Transplantation Proceedings

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Background Pulmonary hypertension has been associated with early allograft dysfunction and increased mortality following renal transplantation however this relationship has not been extensively studied. Methods We performed a retrospective cohort study of adult patients who underwent their first renal transplantation from 2003–2009 and had pre-transplantation echocardiograms. Pulmonary hypertension was defined as a right ventricular systolic pressure ≥ 40 mmHg in the absence of left-sided valvular disease and/or left ventricular ejection fraction ≤ 50%. The relationship between pulmonary hypertension and death-censored allograft failure (hemodialysis dependence or re-transplantation) and serum creatinine was assessed using Cox hazard regression and generalized mixed models. Eighty-two of 205 (40%) patients met inclusion criteria. Results The presence of pulmonary hypertension was associated with a 3.00 fold increase in the risk of death-censored allograft failure (95% confidence interval 1.20 – 7.32, p=0.02). Failure rates were 19% at 24 months and 51% at 96 months for those with pulmonary hypertension versus 7% at 24 months and 20% at 86 months for those without pulmonary hypertension (p=0.01). Among those without graft failure, there was an increase in creatinine levels after transplant (p=0.01). Effect estimates were unchanged by adjustment for multiple covariates and when pulmonary hypertension was defined as a right ventricular systolic pressure ≥ 36 mmHg. Conclusions Pulmonary hypertension prior to renal transplantation carries a 3.00-fold increased risk of death-censored allograft failure. The relationship between the pulmonary circulation and renal allograft failure warrants further study.

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“…In the absence of right ventricular outflow obstruction or pulmonary stenosis, non-invasive determination of pulmonary artery pressure by Doppler echocardiography has been shown to be closely correlated with that measured on catheterization [9,10]. …”

Section: Methodsmentioning

confidence: 99%

Renal transplant improves pulmonary hypertension in patients with end stage renal disease

Bozbas

Kanyilmaz

Akçay

et al. 2011

Multidisciplinary Respiratory Medicine

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BackgroundPulmonary hypertension (PH) is present in a significant proportion of patients with end stage renal disease (ESRD) and is of prognostic importance. Data on the effect of renal transplant on PH is very limited. In this study, the aim was to examine the effect of renal transplant on systolic pulmonary artery pressure (SPAP) determined by Doppler echocardiography.MethodsAnalysis was performed on the records of 500 consecutive patients who underwent renal transplant at our center between the years 1999 to 2008. The prevalence of PH in the preoperative assessment period was established. Patients were diagnosed as having PH when measured SPAP values were > 35 mm Hg.ResultsPulmonary hypertension was detected in 85 of the 500 (17%) patients under pre-transplant evaluation. At post-transplant follow up Doppler echocardiographic examination was performed on 50 of the 85 patients. After exclusion of 8 cases (1 due to massive pulmonary thromboemboli; 7 due to graft failure requiring dialysis therapy) analyses were performed on 42 patients who had undergone both pre- and post-transplant echocardiographic examination. Mean SPAP at pre-transplant evaluation was 45.9 ± 8.8 mm Hg and in 6 (14.3%) cases SPAP was above 50 mm Hg.Compared to pre-transplant values, a significant decrease was observed in mean SPAP values in an average of 53 months of postoperative follow up (41.8 ± 7.4 mm Hg vs. 45.9 ± 8.8 mm Hg, p < 0.0001).ConclusionThese findings indicate that patients with ESRD accompanied by PH may benefit from renal transplant. Further research is required for more concrete conclusions to be drawn on this subject.

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Noninvasive Assessment of Pulmonary Hypertension: A Simultaneous Echo-Doppler Hemodynamic Study

Cited by 27 publications

References 10 publications

The long‐term effects of arteriovenous fistula creation on the development of pulmonary hypertension in hemodialysis patients

The long‐term effects of arteriovenous fistula creation on the development of pulmonary hypertension in hemodialysis patients

Echocardiographic Pulmonary Hypertension Predicts Post-transplantation Renal Allograft Failure

Renal transplant improves pulmonary hypertension in patients with end stage renal disease

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