TY - JOUR
T1 - A Clinical Approach to Multimodality Imaging in Pulmonary Hypertension
AU - Farrell, Christine
AU - Balasubramanian, Aparna
AU - Hays, Allison G.
AU - Hsu, Steven
AU - Rowe, Steven
AU - Zimmerman, Stefan L.
AU - Hassoun, Paul M.
AU - Mathai, Stephen C.
AU - Mukherjee, Monica
N1 - Funding Information:
Funding for this work was supported by the American Lung Association (AB), NIH/NHLBI R01HL147660-03 (AH), NIH/NHLBI R01-HL114910 (PH), NIH/NHLBI K23-HL146889 (SH), Jerome Green Foundation (SH), Scleroderma Foundation (MM and SM), Department of Defense W81XWH2010768 (SM), and Johns Hopkins Clinician Scientist Award (MM).
Publisher Copyright:
© 2022 Farrell, Balasubramanian, Hays, Hsu, Rowe, Zimmerman, Hassoun, Mathai and Mukherjee.
PY - 2022
Y1 - 2022
N2 - 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.
AB - 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.
KW - computed tomography
KW - echocardiography
KW - magnetic resonance imaging
KW - pulmonary hypertension
KW - scintigraphy
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U2 - 10.3389/fcvm.2021.794706
DO - 10.3389/fcvm.2021.794706
M3 - Review article
C2 - 35118142
AN - SCOPUS:85141819653
SN - 2297-055X
VL - 8
JO - Frontiers in Cardiovascular Medicine
JF - Frontiers in Cardiovascular Medicine
M1 - 794706
ER -