Multimodality Imaging of Pulmonary Hypertension
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(2020) 22:50
Imaging (Q Truong, Section Editor)
Multimodality Imaging of Pulmonary Hypertension Pritha Subramanyam, MD1 Christiane Abouzeid, MD2 Lauren K. Groner, DO, DABR3,* Address 1 Division of Cardiology, New York-Presbyterian Hospital-Weill Cornell Medical Center, 68th Street, New York, NY, 10065, USA 2 Division of Cardiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA *,3 Division of Radiology, New York-Presbyterian Hospital-Weill Cornell Medical Center, 68th Street, Box 141, New York, NY, 10065, USA Email: [email protected]
* Springer Science+Business Media, LLC, part of Springer Nature 2020
This article is part of the Topical Collection on Imaging Keywords Pulmonary hypertension I Echocardiography I Chest radiography I Chest CT I Cardiovascular CT I Cardiac MRI
Abstract Purpose of review Pulmonary hypertension (PH) is a complex, progressive abnormal physiologic and hemodynamic state seen in many conditions. The purpose of this review is to discuss the updated clinical and hemodynamic classification systems and diagnostic criteria of PH, discuss the role of noninvasive imaging for diagnosing PH, and outline a diagnostic pathway to facilitate targeted therapies. Recent findings PH is defined as a mean pulmonary arterial pressure (mPAP) 9 20 mmHg since the sixth World Symposium on Pulmonary Hypertension (WSPH) in 2018, a lower threshold than the longstanding definition of mPAP 9 25 mmHg. Additionally, in 2018, Truong et al. established a four-tier classification for the diagnosis of PH based upon the degree of main pulmonary artery enlargement on computed tomography, whereby the likelihood of PH increases with increasing tier severity. Other noninvasive modalities, particularly echocardiography and cardiac magnetic resonance imaging (CMR), aid in prognostication of PH and drive clinical decision-making and treatment strategies. Summary Multimodality imaging is paramount in the screening, diagnosis, and management of PH by providing anatomical, physiologic, functional, and prognostic information. Cumulative findings on echocardiography, ventilation/perfusion scintigraphy, computed tomography, and CMR imaging can often identify the etiology of PH and provide insight into pathophysiology and disease stage.
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Curr Treat Options Cardio Med
(2020) 22:50
Introduction Pulmonary hypertension: definition, classification, and epidemiology Pulmonary hypertension (PH) is an abnormal hemodynamic and physiological state in multiple conditions, defined since 2018 by the sixth World Symposium on Pulmonary Hypertension (WSPH) as a mean pulmonary arterial pressure (mPAP) 9 20 mmHg, a lower threshold than the longstanding definition of mPAP 9 25 mmHg established by the first WSPH in 1973 [1, 2••]. The World Health Organization (WHO) categorizes PH into five groups based on underlying mechanism, clinical presentation, pathological findings, hemodynamic characteristics, and treatment strategies: (1) group 1, pulmonary arterial hypertension (PAH); (2) group 2, PH d
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