Hemodynamical Approach to Pulmonary Hypertension
Downloads
Pulmonary hypertension (PH) is a pathophysiological disorder characterized by a vascular obstruction leading to increased right ventricular overload. It can be caused by multiple conditions that we classify into 5 clinical groups. PH is defined hemodynamically and the role and indications of cardiac catheterization are increasingly important. The subject includes a panoply of pathologies with great complexity at the same time physio-pathological, histo-etiopathogenic, genetic... which are gathered under one chapter: the pulmonary vascular pathology. Right heart catheterization (RHC) is crucial and allows to measure and calculate variables to determine patients hemodynamics that are necessary for positive, etiological and severity diagnosis. It can also have therapeutic purpose: vasoreactivity test (APVT), pre-gesture assessment.
Materiel and Methods: retrospective cross-sectional study of 143 patients with suspicion of pulmonary hypertension whom underwent RHC (left heart) performed between January 2017 and December 2021 in cardiology A department within Ibn Sina university hospital center.
Results: In terms of the results of our study, we have a very diverse review in which PH is assessed at different levels for all groups and subgroups using a multitude of hemodynamic parameters. Our population is characterized by a clear predominance of women
The average age of all 143 cases is 38 years. In terms of hemodynamic classification, isolated pre-capillary PH is the most common (52%). 64% of our cases had PVRs >2 Wu indicating the prevalence of pulmonary vasculopathy. Group 3 represents the population with the most preserved hemodynamical severity parameters. The main vasoreactivity test performed was the NO test.
Humbert M, Sitbon O, Chaouat A, Bertocchi M, Habib G, Gressin V, et al. Pulmonary arterial hypertension in France: results from a national registry. Am J Respir Crit Care Med. 1 mai 2006;173(9):1023‑30.
Clinical Characteristics of Pulmonary Hypertension in Patients With Heart Failure and Preserved Ejection Fraction | Circulation: Heart Failure [Internet].Available on :
https://www.ahajournals.org/doi/10.1161/circheartfailure.110.958801
Vonk Noordegraaf A, Groeneveldt JA, Bogaard HJ. Pulmonary hypertension. Eur Respir Rev Off J Eur Respir Soc. mars 2016;25(139):4‑11.
2022 ESC/ERS Guidelines for the Diagnosis and Treatment of Pulmonary Hypertension: Developed by the Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS). Eur Heart J 2022;Aug 26:
Chronic Thromboembolic Pulmonary Hypertension (CTEPH) | Circulation [Internet].. Available on: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.110.015008.
All Content should be original and unpublished.