Abstract
Pulmonary arterial hypertension (PAH) is a rare, progressive disease in which there is a persistent, abnormal increase in pulmonary artery pressure. Symptoms of pulmonary hypertension are nonspecific and mainly associated with progressive right ventricular failure. The diagnosis of PAH is a multistep process and often requires the skillful use of several tests. The gold standard for the diagnosis of PAH is hemodynamic testing. Echocardiography currently plays an important role in the diagnostic algorithm of PAH as it is minimally invasive and readily available. Moreover, many echocardiographic parameters are closely related to pulmonary hemodynamics. It allows assessment of the right heart′s structure and function, estimation of the pressure in the right ventricle, right atrium, and pulmonary trunk, and exclusion of other causes of elevated pulmonary bed pressure. Echocardiographic techniques are constantly evolving, and recently, measurements made using new techniques, especially 3D visualization, have become increasingly important. In echocardiographic assessment, it is crucial to know current guidelines and new reports that organize the methodology and allow standardization of the examination. This review aims to discuss the different echocardiographic techniques used to evaluate patients with PAH.
Highlights
Pulmonary arterial hypertension (PAH) is a hemodynamic condition characterized by a persistent, abnormal increase in pulmonary artery pressure
Another valuable parameter that determines the shape of the left ventricle is the left ventricular eccentricity index (EI), which is defined as the ratio of the anterior–inferior and septal–posterolateral cavity dimensions at the mid-ventricular level
The results of this study showed that an EI ≥ 1.7, combined with a tricuspid annular plane systolic excursion (TAPSE) ≤ 15 mm, was associated with a higher rate of death and cardiac transplantation compared to patients with normal values [22]
Summary
Pulmonary arterial hypertension (PAH) is a hemodynamic condition characterized by a persistent, abnormal increase in pulmonary artery pressure. The European Society of Cardiology has proposed the following clinical classification in which PAH is divided into the following subtypes: idiopathic, hereditary, associated with other diseases such as systemic connective tissue diseases or heart defects, as well as drug or toxin-induced [2,3]. Clinical assessment of the patient plays a key role in selecting the treatment, observing the patient0 s response to treatment, and potential escalation of the therapy [5,6]. Echocardiography plays an important role in the diagnosis of PAH as it is noninvasive and readily available. Many echocardiographic parameters are closely related to pulmonary hemodynamics [8]. Echocardiographic data provides a wealth of relevant information underpinning clinical management [9].
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