Echocardiographic Ratio Shows Pre- and Post-Capillary Pulmonary Hypertension - The Cardiology Advisor

Echocardiographic Ratio Shows Pre- and Post-Capillary Pulmonary Hypertension - The Cardiology Advisor

Echocardiographic Ratio Shows Pre- and Post-Capillary Pulmonary Hypertension - The Cardiology Advisor

Posted: 25 Jun 2019 01:00 AM PDT

In patients with pulmonary hypertension (PH), echocardiographic pulmonary to left atrial global strain ratio accurately discriminated between pre-capillary and post-capillary PH, according to a study published in the International Journal of Cardiology.

Researchers evaluated the ability of echocardiographic pulmonary to left atrial global strain ratio to differentiate pre-capillary and post-capillary PH to see whether echocardiographic pulmonary to left atrial ratio or echocardiographic pulmonary to left atrial global strain ratio had a superior diagnostic capacity. Patients with unexplained dyspnea or heart failure who were referred for right heart catheterization were included in this study.

Transthoracic echocardiography measured left ventricular ejection fraction, wave Doppler measured max tricuspid regurgitation peak velocity, and speckle tracking echocardiography measured left atrial global strain. These measurements were used to calculate echocardiographic pulmonary to left atrial global strain ratio. Right heart catheterization was used to measure mean right atrial pressure and pulmonary artery pressure.

Of the 130 patients included in this study, 64 demonstrated pre-capillary PH, 66 demonstrated post-capillary PH, with 39 classified as isolated post-capillary PH, and 27 demonstrated combined post- and pre-capillary PH.

When analyzing the baseline characteristics, echocardiographic pulmonary to left atrial global strain ratio was lower in pre-capillary PH than post-capillary PH (0.19 vs 0.45; P =.02), and echocardiographic pulmonary to left atrial ratio was higher in pre-capillary PH compared with post-capillary PH (0.37 vs 0.20; P <.001). Echocardiographic pulmonary to left atrial global strain ratio differentiated between isolated post-capillary PH and combined post- and pre-capillary PH (0.62 vs 0.32; P =.04) and was associated with pulmonary vascular resistance (r =0.28; P =.02) and transpulmonary gradient (r =0.30; P =.01).

The diagnostic capability to distinguish pre-capillary and post-capillary PH favored echocardiographic pulmonary to left atrial global strain ratio (area under the curve [AUC] 0.80; 95% CI, 0.72-0.89; P <.001) over echocardiographic pulmonary to left atrial ratio (AUC 0.70; 95% CI, 0.61-0.80; P <.001).

Related Articles

Limitations of this study included a lack of standard image acquisition, the absence of a control cohort, potential errors in the variable used to calculate echocardiographic pulmonary to left atrial global strain ratio, and the inclusion of symptomatic patients in the post-capillary PH cohort.

The researchers concluded that "[t]he novel [echocardiographic pulmonary to left atrial global strain] ratio distinguishes pre-capillary from post-capillary PH and demonstrates a stronger differentiating capability as compared to [echocardiographic pulmonary to left atrial ratio]."

Reference

Venkateshvaran A, Manouras A, Kjellström B, Lund LH. The additive value of echocardiographic pulmonary to left atrial global strain ratio in the diagnosis of pulmonary hypertension [published online May 31, 2019]. Int J Cardiol. doi:10.1016/j.ijcard.2019.05.025

Topics:

Pulmonary Hypertension Pulmonary Vasculature

Comments

Post a Comment

Popular posts from this blog

Epoprostenol Via High-Flow Nasal Cannula Improves Severe Hypoxemia in PH - Pulmonology Advisor

Image
Epoprostenol Via High-Flow Nasal Cannula Improves Severe Hypoxemia in PH - Pulmonology Advisor Epoprostenol Via High-Flow Nasal Cannula Improves Severe Hypoxemia in PH - Pulmonology Advisor Posted: 11 Jul 2019 12:00 AM PDT For patients with severe hypoxemia with pulmonary hypertension or right heart dysfunction, inhaled epoprostenol through high-flow nasal cannula increases oxygenation, according to a study published in Pharmaceutics . The researchers of this retrospective study assessed the effect of inhaled epoprostenol using a high-flow nasal cannula on oxygenation and future mechanical ventilation in patients with hypoxemia comorbid with pulmonary hypertension or right heart dysfunction in an intensive care unit setting. A chart review was completed on adult patients who were admitted into the respiratory care department of the Rush University Medical Center for severe hypoxemia between July 2015 and April 2018 and treated with inha...
Read more

Dyspnea (Shortness of Breath): Causes, Symptoms & Treatment - my.clevelandclinic.org

Image
Overview Shortness of breath (dyspnea) is most commonly caused by heart or lung conditions. Other causes include anemia, anxiety, lack of exercise or living with obesity. What is dyspnea (shortness of breath)? Dyspnea (pronounced "DISP-nee-uh") is the word healthcare providers use for feeling short of breath. You might describe it as not being able to get enough air ("air hunger"), chest tightness or working harder to breathe. Shortness of breath is often a symptom of heart and lung problems. But it can also be a sign of other conditions like asthma, allergies or anxiety. Intense exercise or having a cold can also make you feel breathless. What are paroxysmal nocturnal dyspnea (PND) and sighing dyspnea? Paroxysmal nocturnal dyspnea (PND) is a feeling like you can't breathe an hour or two after falling asleep. Sighing dyspnea is when you sigh a lot after taking deep breaths in to try to relieve the feeling of dyspnea. What is the differ...
Read more

What to Expect During Pulmonary Embolism Recovery - Healthline

Image
What to Expect During Pulmonary Embolism Recovery - Healthline What to Expect During Pulmonary Embolism Recovery - Healthline Pulmonary Arterial Hypertension: Updates in Epidemiology and Evaluation of Patients - AJMC.com Managed Markets Network Right-Sided Heart Failure: Symptoms, Causes, and Treatments - Healthline Right sided heart failure: Symptoms, outlook, treatment - Medical News Today What to Expect During Pulmonary Embolism Recovery - Healthline Posted: 19 May 2021 12:00 AM PDT A pulmonary embolism (PE) is when a blood clot becomes stuck in the blood vessels of your lung. These clots typically begin in the leg and then break free and travel to the lung. The American Lung Association estimates that about 1 in 1,000 people in the United States experience a PE each year. A PE can be a serious or life threatening condition, which means receiving prompt medical treatment is vital. Treatment of a PE focus...
Read more