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Hemodynamic indices in pulmonary hypertension: a narrative review

BACKGROUND AND OBJECTIVE: Pulmonary hypertension (PH) is defined as a mean pulmonary artery pressure (mPAP) >20 mmHg and its presence is associated with worse outcomes. A comprehensive hemodynamic evaluation of the pulmonary circulation is essential for diagnosis, hemodynamic classification, and...

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Autores principales: Manek, Gaurav, Gupta, Manasvi, Chhabria, Mamta, Bajaj, Divyansh, Agrawal, Ankit, Tonelli, Adriano R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9622402/
https://www.ncbi.nlm.nih.gov/pubmed/36329964
http://dx.doi.org/10.21037/cdt-22-244
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author Manek, Gaurav
Gupta, Manasvi
Chhabria, Mamta
Bajaj, Divyansh
Agrawal, Ankit
Tonelli, Adriano R.
author_facet Manek, Gaurav
Gupta, Manasvi
Chhabria, Mamta
Bajaj, Divyansh
Agrawal, Ankit
Tonelli, Adriano R.
author_sort Manek, Gaurav
collection PubMed
description BACKGROUND AND OBJECTIVE: Pulmonary hypertension (PH) is defined as a mean pulmonary artery pressure (mPAP) >20 mmHg and its presence is associated with worse outcomes. A comprehensive hemodynamic evaluation of the pulmonary circulation is essential for diagnosis, hemodynamic classification, and prognostication. A multitude of indices assess different aspects of the pulmonary circulation but there are no reviews that describe their specific value in PH. METHODS: We performed a thorough literature search of relevant articles in English from 1970–2021 using PubMed. KEY CONTENT AND FINDINGS: In this article, we present both static and dynamic indices used for the hemodynamic assessment of PH. While some of these indices are routinely used in clinical practice, including cardiac index (CI), stroke volume (SV), and pulmonary vascular resistance (PVR); others such as pulmonary artery compliance (PAC), pulmonary effective arterial elastance (Ea), and pulmonary artery pulsatility index (PAPi) are gaining popularity by enhancing the understanding of different aspects of the pulmonary circulation. We described the advantages and pitfalls of various indices, including when to use them in the hemodynamic evaluation of patients with PH. CONCLUSIONS: A variety of indices measuring different aspects of the right ventricle (RV)-pulmonary arteries (PA) system provide valuable information in patients with PH. However, it remains important to develop and validate indices that provide a comprehensive hemodynamic evaluation to improve outcomes in patients with PH.
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spelling pubmed-96224022022-11-02 Hemodynamic indices in pulmonary hypertension: a narrative review Manek, Gaurav Gupta, Manasvi Chhabria, Mamta Bajaj, Divyansh Agrawal, Ankit Tonelli, Adriano R. Cardiovasc Diagn Ther Review Article BACKGROUND AND OBJECTIVE: Pulmonary hypertension (PH) is defined as a mean pulmonary artery pressure (mPAP) >20 mmHg and its presence is associated with worse outcomes. A comprehensive hemodynamic evaluation of the pulmonary circulation is essential for diagnosis, hemodynamic classification, and prognostication. A multitude of indices assess different aspects of the pulmonary circulation but there are no reviews that describe their specific value in PH. METHODS: We performed a thorough literature search of relevant articles in English from 1970–2021 using PubMed. KEY CONTENT AND FINDINGS: In this article, we present both static and dynamic indices used for the hemodynamic assessment of PH. While some of these indices are routinely used in clinical practice, including cardiac index (CI), stroke volume (SV), and pulmonary vascular resistance (PVR); others such as pulmonary artery compliance (PAC), pulmonary effective arterial elastance (Ea), and pulmonary artery pulsatility index (PAPi) are gaining popularity by enhancing the understanding of different aspects of the pulmonary circulation. We described the advantages and pitfalls of various indices, including when to use them in the hemodynamic evaluation of patients with PH. CONCLUSIONS: A variety of indices measuring different aspects of the right ventricle (RV)-pulmonary arteries (PA) system provide valuable information in patients with PH. However, it remains important to develop and validate indices that provide a comprehensive hemodynamic evaluation to improve outcomes in patients with PH. AME Publishing Company 2022-10 /pmc/articles/PMC9622402/ /pubmed/36329964 http://dx.doi.org/10.21037/cdt-22-244 Text en 2022 Cardiovascular Diagnosis and Therapy. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Review Article
Manek, Gaurav
Gupta, Manasvi
Chhabria, Mamta
Bajaj, Divyansh
Agrawal, Ankit
Tonelli, Adriano R.
Hemodynamic indices in pulmonary hypertension: a narrative review
title Hemodynamic indices in pulmonary hypertension: a narrative review
title_full Hemodynamic indices in pulmonary hypertension: a narrative review
title_fullStr Hemodynamic indices in pulmonary hypertension: a narrative review
title_full_unstemmed Hemodynamic indices in pulmonary hypertension: a narrative review
title_short Hemodynamic indices in pulmonary hypertension: a narrative review
title_sort hemodynamic indices in pulmonary hypertension: a narrative review
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9622402/
https://www.ncbi.nlm.nih.gov/pubmed/36329964
http://dx.doi.org/10.21037/cdt-22-244
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