Role of Vasodilator Testing in Pulmonary Hypertension

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• 作者：Abhishek Sharma^a ; ^{abhisheksharma4mamc@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Chukwudi Obiagwu^b ; Kenechukwu Mezue^c ; Aakash Garg^d ; Debabrata Mukherjee^e ; Jennifer Haythe^f ; Vijay Shetty^b ; Andrew J. Einstein^g
• 关键词：CCB ; calcium channel blockers ; CO ; cardiac output ; HF ; heart failure ; IPAH ; idiopathic pulmonary arterial hypertension ; i NO ; inhaled nitric oxide ; LSHD ; left sided heart disease ; LV ; left ventricular ; MRI ; magnetic resonance imaging ; NO ; nitric oxide ; PA ; pulmonary artery ; PAH ; pulmonary arterial hypertension ; PAP ; pulmonary artery pressure ; PAWP ; pulmonary artery wedge pressure ; PGI2 ; prostacyclin ; PH ; pulmonary hypertension ; PVR ; pulmonary vascular resistance ; PVH ; pulmonary venous hypertensi
• 刊名：Progress in Cardiovascular Diseases
• 出版年：2016
• 出版时间：January-February 2016
• 年：2016
• 卷：58
• 期：4
• 页码：425-433
• 全文大小：348 K

文摘

Pulmonary hypertension is clinically defined by a mean pulmonary artery (PA) pressure of 25 mm Hg or more at rest, as measured by right heart catheterization. To identify patients who are likely to have a beneficial response to calcium channel blockers (CCBs) and therefore a better prognosis, acute vasodilator testing should be performed in patients in certain subsets of pulmonary arterial hypertension (PAH). A near normalization of pulmonary hemodynamics is needed before patients can be considered for therapy with CCBs. Intravenous adenosine, intravenous epoprostenol, inhaled nitric oxide, or inhaled iloprost are the standard agents used for vasoreactivity testing in patients with idiopathic PAH. In this review we describe the various aspects of vasodilator testing including the rationale, pathophysiology and agents used in the procedure.