Follow-Up of Pulmonary Hypertension With Echocardiography

Abstract 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 chang...

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Bibliographic Details
Published in:JACC. Cardiovascular imaging 2016-06, Vol.9 (6), p.733-746
Main Authors: Wright, Leah M., BS, Dwyer, Nathan, MBBS, PhD, Celermajer, David, MBBS, PhD, DSc, Kritharides, Len, MBBS, PhD, Marwick, Thomas H., MBBS, PhD, MPH
Format: Article
Language:English
Subjects:
Arterial Pressure
Cardiovascular
echocardiography
Echocardiography, Doppler
follow-up
Hemodynamics
Humans
Hypertension, Pulmonary - diagnostic imaging
Hypertension, Pulmonary - mortality
Hypertension, Pulmonary - physiopathology
Hypertension, Pulmonary - therapy
Image Interpretation, Computer-Assisted
magnetic resonance imaging
Predictive Value of Tests
Pulmonary Artery - diagnostic imaging
Pulmonary Artery - physiopathology
pulmonary hypertension
Risk Factors
RV function
Treatment Outcome
Ventricular Function, Left
Ventricular Function, Right
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Summary:Abstract 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.
ISSN:1936-878X
1876-7591
DOI:10.1016/j.jcmg.2016.02.022