title: Non-Invasive Assessment of Pulmonary Vascular Resistance in Pulmonary Hypertension: Current Knowledge and Future Direction.
abstract: Pulmonary Hypertension (PHT) is relatively common, dangerous and under-recognised. Pulmonary hypertension is not a diagnosis in itself; it is caused by a number of differing diseases each with different treatments and prognoses. Therefore, timely and accurate recognition of the underlying cause for PHT is essential for appropriate management. This is especially true for patients with Pulmonary Arterial Hypertension (PAH) in the current era of disease-specific drug therapy. Measurement of Pulmonary Vascular Resistance (PVR) helps separate pre-capillary from post-capillary PHT, and is measured with right heart catheterisation (RHC). Echocardiography has been used to derive a number of non-invasive surrogates for PVR, with varying accuracy. Ultimately, the goal of non-invasive assessment of PVR is to separate PHT due to left heart disease from PHT due to increased PVR, to help streamline investigation and subsequent treatment. In this review, we summarise the physiology and pathophysiology of pulmonary blood flow, the various causes of pulmonary hypertension, and non-invasive surrogates for PVR.
authors.affiliation: University of Notre Dame Australia, Fremantle, WA, Australia; Mount Hospital, Perth, WA, Australia. Electronic address: kopyinaing@gmail.com.
authors.forename: Pyi
authors.initials: P
authors.lastname: Naing
authors.affiliation: University of Notre Dame Australia, Fremantle, WA, Australia; Mount Hospital, Perth, WA, Australia.
authors.forename: Harveen
authors.initials: H
authors.lastname: Kuppusamy
authors.affiliation: Prince Charles Hospital, Brisbane, Qld, Australia.
authors.forename: Gregory
authors.initials: G
authors.lastname: Scalia
authors.affiliation: Royal Perth Hospital, Perth, WA, Australia.
authors.forename: Graham S
authors.initials: GS
authors.lastname: Hillis
authors.affiliation: University of Notre Dame Australia, Fremantle, WA, Australia; Mount Hospital, Perth, WA, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Playford
mesh_terms: D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology*; D011379:Prognosis; D014655:Vascular Resistance
keywords: Doppler echocardiography; Heart failure with preserved ejection fraction (HFpEF); Pulmonary arterial hypertension; Pulmonary hypertension (PHT); Pulmonary vascular resistance (PVR)