The Role of Exercise Doppler Echocardiography to Unmask Pulmonary Arterial Hypertension in Selected Patients with Systemic Sclerosis and Equivocal Baseline Echocardiographic Values for Pulmonary Hypertension
| Autor: | Anastasia Anthi, Iraklis Tsangaris, Christos Varounis, Stylianos E. Orfanos, Efstathios K. Iliodromitis, Dimitrios Konstantonis, P. G. Vlachoyiannopoulos, Loukianos S. Rallidis, G Makavos, Konstantina Papangelopoulou |
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| Rok vydání: | 2021 |
| Předmět: |
Inotrope
Medicine (General) medicine.medical_specialty systemic sclerosis Clinical Biochemistry Diagnostic accuracy PRESSURE 030204 cardiovascular system & hematology Doppler echocardiography Pulmonary arterial pressure DOBUTAMINE RECOMMENDATIONS DISEASE Article 03 medical and health sciences R5-920 Medicine General & Internal STRESS ECHOCARDIOGRAPHY 0302 clinical medicine General & Internal Medicine Internal medicine pulmonary arterial hypertension medicine Treadmill AMERICAN SOCIETY exercise Doppler echocardiography EUROPEAN ASSOCIATION 030203 arthritis & rheumatology Science & Technology medicine.diagnostic_test business.industry RIGHT HEART medicine.disease Pulmonary hypertension medicine.anatomical_structure Ventricle Rv function RISK-FACTORS Cardiology UPDATE business Life Sciences & Biomedicine |
| Zdroj: | Diagnostics Diagnostics; Volume 11; Issue 7; Pages: 1200 Diagnostics, Vol 11, Iss 1200, p 1200 (2021) |
| ISSN: | 2075-4418 |
| Popis: | Recently, a lower mean pulmonary arterial pressure (PAP) cutoff of >20 mmHg for pulmonary hypertension (PH) definition has been proposed. We examined whether exercise Doppler echocardiography (EDE) can unmask PA hypertension (PAH) in systemic sclerosis (SSc) patients whose baseline echocardiography for PH is equivocal. We enrolled 49 patients with SSc who underwent treadmill EDE. Tricuspid regurgitation (TR) velocity was recorded immediately after EDE. Inotropic reserve of right ventricle (RV) was assessed by the change (post-prior to exercise) of tissue Doppler imaging-derived peak systolic velocity (S) of tricuspid annulus. Inclusion criteria comprised preserved left and RV function, and baseline TR velocity between 2.7 and 3.2 m/s. All patients had right-heart catheterization (RHC) within 48 h after EDE. From 46 patients with good quality of post-exercise TR velocity, RHC confirmed PAH in 21 (45.6%). Post-exercise TR velocity >3.4 m/s had a sensitivity of 90.5%, a specificity of 80% and an accuracy of 84.8% in detecting PAH. Inotropic reserve of RV was positively correlated with maximum achieved workload in METs (r = 0.571, p < 0.001). EDE has a good diagnostic accuracy for the identification of PAH in selected SSc patients whose baseline echocardiographic measurements for PH lie in the gray zone, and it is also potentially useful in assessing RV contractile reserve. ispartof: DIAGNOSTICS vol:11 issue:7 ispartof: location:Switzerland status: published |
| Databáze: | OpenAIRE |
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