Cargando…

Early histological changes of pulmonary arterial hypertension disclosed by invasive cardiopulmonary exercise testing

Early diagnosis of pulmonary artery hypertension (PAH) is diagnostically challenging given the extent of pulmonary vascular remodeling required to bring about clinical signs and symptoms. Exercise testing can be invaluable in this setting, as stressing the cardiopulmonary system may unmask early dis...

Descripción completa

Detalles Bibliográficos
Autores principales: Bhatti, Yousaf J., Rice, Alexandra J., Kempny, Aleksander, Dimopoulos, Konstantinos, Price, Laura C., Ranu, Harpreet, Wells, Athol, Wort, S. John, McCabe, Colm
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469282/
https://www.ncbi.nlm.nih.gov/pubmed/30945593
http://dx.doi.org/10.1177/2045894019845615
_version_ 1783411615748587520
author Bhatti, Yousaf J.
Rice, Alexandra J.
Kempny, Aleksander
Dimopoulos, Konstantinos
Price, Laura C.
Ranu, Harpreet
Wells, Athol
Wort, S. John
McCabe, Colm
author_facet Bhatti, Yousaf J.
Rice, Alexandra J.
Kempny, Aleksander
Dimopoulos, Konstantinos
Price, Laura C.
Ranu, Harpreet
Wells, Athol
Wort, S. John
McCabe, Colm
author_sort Bhatti, Yousaf J.
collection PubMed
description Early diagnosis of pulmonary artery hypertension (PAH) is diagnostically challenging given the extent of pulmonary vascular remodeling required to bring about clinical signs and symptoms. Exercise testing can be invaluable in this setting, as stressing the cardiopulmonary system may unmask early disease. This report describes a young patient with a positive family history of PAH in whom contemporaneous invasive cardiopulmonary exercise testing and surgical lung biopsy reveal the novel association between exercise pulmonary hypertension (ePH) and early histological changes of PAH. Exercise PH currently carries no pathological correlates which means the hemodynamic effects of early pulmonary vascular remodeling remain unknown. Following the recent proceedings from the World Symposium in Pulmonary Hypertension 2018, which broaden the hemodynamic definition of PAH, this report suggests an important association between ePH and early pulmonary vascular remodeling supporting a role for exercise hemodynamic evaluation in patients at increased familial risk of PAH.
format Online
Article
Text
id pubmed-6469282
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-64692822019-04-24 Early histological changes of pulmonary arterial hypertension disclosed by invasive cardiopulmonary exercise testing Bhatti, Yousaf J. Rice, Alexandra J. Kempny, Aleksander Dimopoulos, Konstantinos Price, Laura C. Ranu, Harpreet Wells, Athol Wort, S. John McCabe, Colm Pulm Circ Case Report Early diagnosis of pulmonary artery hypertension (PAH) is diagnostically challenging given the extent of pulmonary vascular remodeling required to bring about clinical signs and symptoms. Exercise testing can be invaluable in this setting, as stressing the cardiopulmonary system may unmask early disease. This report describes a young patient with a positive family history of PAH in whom contemporaneous invasive cardiopulmonary exercise testing and surgical lung biopsy reveal the novel association between exercise pulmonary hypertension (ePH) and early histological changes of PAH. Exercise PH currently carries no pathological correlates which means the hemodynamic effects of early pulmonary vascular remodeling remain unknown. Following the recent proceedings from the World Symposium in Pulmonary Hypertension 2018, which broaden the hemodynamic definition of PAH, this report suggests an important association between ePH and early pulmonary vascular remodeling supporting a role for exercise hemodynamic evaluation in patients at increased familial risk of PAH. SAGE Publications 2019-04-16 /pmc/articles/PMC6469282/ /pubmed/30945593 http://dx.doi.org/10.1177/2045894019845615 Text en © The Author(s) 2019 http://creativecommons.org/licenses/by-nc/4.0/ Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Report
Bhatti, Yousaf J.
Rice, Alexandra J.
Kempny, Aleksander
Dimopoulos, Konstantinos
Price, Laura C.
Ranu, Harpreet
Wells, Athol
Wort, S. John
McCabe, Colm
Early histological changes of pulmonary arterial hypertension disclosed by invasive cardiopulmonary exercise testing
title Early histological changes of pulmonary arterial hypertension disclosed by invasive cardiopulmonary exercise testing
title_full Early histological changes of pulmonary arterial hypertension disclosed by invasive cardiopulmonary exercise testing
title_fullStr Early histological changes of pulmonary arterial hypertension disclosed by invasive cardiopulmonary exercise testing
title_full_unstemmed Early histological changes of pulmonary arterial hypertension disclosed by invasive cardiopulmonary exercise testing
title_short Early histological changes of pulmonary arterial hypertension disclosed by invasive cardiopulmonary exercise testing
title_sort early histological changes of pulmonary arterial hypertension disclosed by invasive cardiopulmonary exercise testing
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469282/
https://www.ncbi.nlm.nih.gov/pubmed/30945593
http://dx.doi.org/10.1177/2045894019845615
work_keys_str_mv AT bhattiyousafj earlyhistologicalchangesofpulmonaryarterialhypertensiondisclosedbyinvasivecardiopulmonaryexercisetesting
AT ricealexandraj earlyhistologicalchangesofpulmonaryarterialhypertensiondisclosedbyinvasivecardiopulmonaryexercisetesting
AT kempnyaleksander earlyhistologicalchangesofpulmonaryarterialhypertensiondisclosedbyinvasivecardiopulmonaryexercisetesting
AT dimopouloskonstantinos earlyhistologicalchangesofpulmonaryarterialhypertensiondisclosedbyinvasivecardiopulmonaryexercisetesting
AT pricelaurac earlyhistologicalchangesofpulmonaryarterialhypertensiondisclosedbyinvasivecardiopulmonaryexercisetesting
AT ranuharpreet earlyhistologicalchangesofpulmonaryarterialhypertensiondisclosedbyinvasivecardiopulmonaryexercisetesting
AT wellsathol earlyhistologicalchangesofpulmonaryarterialhypertensiondisclosedbyinvasivecardiopulmonaryexercisetesting
AT wortsjohn earlyhistologicalchangesofpulmonaryarterialhypertensiondisclosedbyinvasivecardiopulmonaryexercisetesting
AT mccabecolm earlyhistologicalchangesofpulmonaryarterialhypertensiondisclosedbyinvasivecardiopulmonaryexercisetesting