Improvement in right ventricular function during reversibility testing in pulmonary arterial hypertension: a case report.
A right heart catheterization with reversibility testing is recommended for the diagnosis and treatment of pulmonary arterial hypertension. In this 24 years-old woman, the inhalation of 5 microg iloprost transiently decreased mean pulmonary artery pressure from 62 to 36 mmHg and pulmonary vascular resistance from 11.0 to 4.9 Wood units, meeting the criteria of a "positive response". The echocardiographic examination showed normalization of right heart chamber dimensions and of the right ventricular performance (Tei) index. Pulsed tissue Doppler imaging of the right ventricle showed a decrease in the isovolumic relaxation time from 102 to 73 ms, and an increase of the E/A ratio from 0.72 to 1.38, together with marked improvements in mid-apical free wall systolic strain and strain rate. A positive response to reversibility testing of pulmonary arterial hypertension may be associated with quasi normalization of right ventricular function, in spite of still elevated pulmonary artery pressure.
Huez
Sandrine
S
Department of Pathophysiology, Erasmus Campus, CP 604, Route de Lennik 808, B-1070 Brussels, Belgium. shuez@ulb.ac.be
Vachiéry
Jean-Luc
JL
Naeije
Robert
R
D000280:Administration, Inhalation; D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D006328:Cardiac Catheterization; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D016285:Iloprost / Q000008:administration & dosage*; D014665:Vasodilator Agents / Q000008:administration & dosage*; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000188:drug therapy*
D014665:Vasodilator Agents; D016285:Iloprost