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A Clinical Approach to Multimodality Imaging in Pulmonary Hypertension

Pulmonary hypertension (PH) is a clinical condition characterized by progressive elevations in mean pulmonary artery pressures and right ventricular dysfunction, associated with significant morbidity and mortality. For resting PH to develop, ~50–70% of the pulmonary vasculature must be affected, sug...

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Autores principales: Farrell, Christine, Balasubramanian, Aparna, Hays, Allison G., Hsu, Steven, Rowe, Steven, Zimmerman, Stefan L., Hassoun, Paul M., Mathai, Stephen C., Mukherjee, Monica
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8804287/
https://www.ncbi.nlm.nih.gov/pubmed/35118142
http://dx.doi.org/10.3389/fcvm.2021.794706
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author Farrell, Christine
Balasubramanian, Aparna
Hays, Allison G.
Hsu, Steven
Rowe, Steven
Zimmerman, Stefan L.
Hassoun, Paul M.
Mathai, Stephen C.
Mukherjee, Monica
author_facet Farrell, Christine
Balasubramanian, Aparna
Hays, Allison G.
Hsu, Steven
Rowe, Steven
Zimmerman, Stefan L.
Hassoun, Paul M.
Mathai, Stephen C.
Mukherjee, Monica
author_sort Farrell, Christine
collection PubMed
description Pulmonary hypertension (PH) is a clinical condition characterized by progressive elevations in mean pulmonary artery pressures and right ventricular dysfunction, associated with significant morbidity and mortality. For resting PH to develop, ~50–70% of the pulmonary vasculature must be affected, suggesting that even mild hemodynamic abnormalities are representative of advanced pulmonary vascular disease. The definitive diagnosis of PH is based upon hemodynamics measured by right heart catheterization; however this is an invasive and resource intense study. Early identification of pulmonary vascular disease offers the opportunity to improve outcomes by instituting therapies that slow, reverse, or potentially prevent this devastating disease. Multimodality imaging, including non-invasive modalities such as echocardiography, computed tomography, ventilation perfusion scans, and cardiac magnetic resonance imaging, has emerged as an integral tool for screening, classifying, prognosticating, and monitoring response to therapy in PH. Additionally, novel imaging modalities such as echocardiographic strain imaging, 3D echocardiography, dual energy CT, FDG-PET, and 4D flow MRI are actively being investigated to assess the severity of right ventricular dysfunction in PH. In this review, we will describe the utility and clinical application of multimodality imaging techniques across PH subtypes as it pertains to screening and monitoring of PH.
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spelling pubmed-88042872022-02-02 A Clinical Approach to Multimodality Imaging in Pulmonary Hypertension Farrell, Christine Balasubramanian, Aparna Hays, Allison G. Hsu, Steven Rowe, Steven Zimmerman, Stefan L. Hassoun, Paul M. Mathai, Stephen C. Mukherjee, Monica Front Cardiovasc Med Cardiovascular Medicine Pulmonary hypertension (PH) is a clinical condition characterized by progressive elevations in mean pulmonary artery pressures and right ventricular dysfunction, associated with significant morbidity and mortality. For resting PH to develop, ~50–70% of the pulmonary vasculature must be affected, suggesting that even mild hemodynamic abnormalities are representative of advanced pulmonary vascular disease. The definitive diagnosis of PH is based upon hemodynamics measured by right heart catheterization; however this is an invasive and resource intense study. Early identification of pulmonary vascular disease offers the opportunity to improve outcomes by instituting therapies that slow, reverse, or potentially prevent this devastating disease. Multimodality imaging, including non-invasive modalities such as echocardiography, computed tomography, ventilation perfusion scans, and cardiac magnetic resonance imaging, has emerged as an integral tool for screening, classifying, prognosticating, and monitoring response to therapy in PH. Additionally, novel imaging modalities such as echocardiographic strain imaging, 3D echocardiography, dual energy CT, FDG-PET, and 4D flow MRI are actively being investigated to assess the severity of right ventricular dysfunction in PH. In this review, we will describe the utility and clinical application of multimodality imaging techniques across PH subtypes as it pertains to screening and monitoring of PH. Frontiers Media S.A. 2022-01-18 /pmc/articles/PMC8804287/ /pubmed/35118142 http://dx.doi.org/10.3389/fcvm.2021.794706 Text en Copyright © 2022 Farrell, Balasubramanian, Hays, Hsu, Rowe, Zimmerman, Hassoun, Mathai and Mukherjee. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Farrell, Christine
Balasubramanian, Aparna
Hays, Allison G.
Hsu, Steven
Rowe, Steven
Zimmerman, Stefan L.
Hassoun, Paul M.
Mathai, Stephen C.
Mukherjee, Monica
A Clinical Approach to Multimodality Imaging in Pulmonary Hypertension
title A Clinical Approach to Multimodality Imaging in Pulmonary Hypertension
title_full A Clinical Approach to Multimodality Imaging in Pulmonary Hypertension
title_fullStr A Clinical Approach to Multimodality Imaging in Pulmonary Hypertension
title_full_unstemmed A Clinical Approach to Multimodality Imaging in Pulmonary Hypertension
title_short A Clinical Approach to Multimodality Imaging in Pulmonary Hypertension
title_sort clinical approach to multimodality imaging in pulmonary hypertension
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8804287/
https://www.ncbi.nlm.nih.gov/pubmed/35118142
http://dx.doi.org/10.3389/fcvm.2021.794706
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