Follow-Up of Pulmonary Hypertension With Echocardiography.
Individual patient response to effective therapies for pulmonary hypertension (PAH) is variable and difficult to quantify. Consequently, management decisions regarding initiation and continuation of therapy are highly dependent on the results of investigations. Registry data show that changes in cardiac index, mean right atrial pressure, and mean pulmonary artery pressure have the greatest influence on survival. It is recognized that pulmonary artery pressure (PASP) responses to PAH-specific drugs are heterogeneous. However, follow-up testing is strongly focused on assessing changes in PASP and functional status (6-min walk). The goals of therapy, which should be highlighted in follow-up imaging, include not only reduction of PASP, decrease in pulmonary vascular resistance, and improvements in right ventricular function, cardiac output, and tricuspid regurgitation. This paper reviews the echocardiographic follow-up of pulmonary hypertension, and especially focuses on right ventricular function-a major determinant of outcome, for which reliable echocardiographic assessment has become more feasible.
Menzies Institute for Medical Research, Hobart, Australia; Royal Hobart Hospital, Hobart, Australia; Baker-IDI Heart and Diabetes Institute, Melbourne, Australia.
Leah M
LM
Wright
Royal Hobart Hospital, Hobart, Australia.
Nathan
N
Dwyer
University of Sydney, Sydney, Australia.
David
D
Celermajer
University of Sydney, Sydney, Australia.
Len
L
Kritharides
Menzies Institute for Medical Research, Hobart, Australia; Royal Hobart Hospital, Hobart, Australia; Baker-IDI Heart and Diabetes Institute, Melbourne, Australia. Electronic address: Tom.Marwick@utas.edu.au.
Thomas H
TH
Marwick
D062186:Arterial Pressure; D015150:Echocardiography, Doppler; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D007090:Image Interpretation, Computer-Assisted; D011237:Predictive Value of Tests; D011651:Pulmonary Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012307:Risk Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right
RV function; echocardiography; follow-up; magnetic resonance imaging; pulmonary hypertension