Hemodynamical Approach to Pulmonary Hypertension

Pulmonary hypertension clinical groups hemodynamics right heart catheterization pre-capillary post-capillary

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March 31, 2023
April 1, 2023

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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.

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