title: Role of Vasodilator Testing in Pulmonary Hypertension.
abstract: Pulmonary hypertension is clinically defined by a mean pulmonary artery (PA) pressure of 25mm Hg or more at rest, as measured by right heart catheterization. To identify patients who are likely to have a beneficial response to calcium channel blockers (CCBs) and therefore a better prognosis, acute vasodilator testing should be performed in patients in certain subsets of pulmonary arterial hypertension (PAH). A near normalization of pulmonary hemodynamics is needed before patients can be considered for therapy with CCBs. Intravenous adenosine, intravenous epoprostenol, inhaled nitric oxide, or inhaled iloprost are the standard agents used for vasoreactivity testing in patients with idiopathic PAH. In this review we describe the various aspects of vasodilator testing including the rationale, pathophysiology and agents used in the procedure.
authors.affiliation: Division of Cardiology, Department of Medicine, State University of New York Downstate Medical Center, NY, USA. Electronic address: abhisheksharma4mamc@gmail.com.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Sharma
authors.affiliation: Department of Medicine, Maimonides Medical Center, NY, USA.
authors.forename: Chukwudi
authors.initials: C
authors.lastname: Obiagwu
authors.affiliation: Department of Medicine, Einstein Medical Center, PA, USA.
authors.forename: Kenechukwu
authors.initials: K
authors.lastname: Mezue
authors.affiliation: Department of Medicine, Saint Peter's University Hospital, NJ, USA.
authors.forename: Aakash
authors.initials: A
authors.lastname: Garg
authors.affiliation: Division of Cardiology, Department of Medicine, Texas Tech University, El Paso, TX, USA.
authors.forename: Debabrata
authors.initials: D
authors.lastname: Mukherjee
authors.affiliation: Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Haythe
authors.affiliation: Department of Medicine, Maimonides Medical Center, NY, USA.
authors.forename: Vijay
authors.initials: V
authors.lastname: Shetty
authors.affiliation: Division of Cardiology, Department of Medicine and Department of Radiology, Columbia University Medical Center, New York, NY, USA.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Einstein
mesh_terms: D000241:Adenosine / Q000008:administration & dosage*; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001993:Bronchodilator Agents / Q000008:administration & dosage; D002121:Calcium Channel Blockers / Q000008:administration & dosage*; D006328:Cardiac Catheterization / Q000379:methods; D011464:Epoprostenol / Q000008:administration & dosage*; D055317:Evidence-Based Practice; D017408:Guidelines as Topic; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D016285:Iloprost / Q000008:administration & dosage*; D001239:Inhalation; D009569:Nitric Oxide / Q000008:administration & dosage; D014664:Vasodilation / Q000187:drug effects; D014665:Vasodilator Agents / Q000008:administration & dosage*
chemical_list: D000959:Antihypertensive Agents; D001993:Bronchodilator Agents; D002121:Calcium Channel Blockers; D014665:Vasodilator Agents; D009569:Nitric Oxide; D011464:Epoprostenol; D016285:Iloprost; D000241:Adenosine
keywords: Pulmonary artery hypertension; Pulmonary hypertension; Vasodilator testing