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Non-invasive Assessment of Right Heart Function and Hemodynamics during Exercise in Patients with Pulmonary Arterial Hypertension.

M. L. Freeman

C. K. Landolfo

Robert Safford

C. A. Keller

M. G. Heckman

Charles Burger


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Conference: 2012 International PHA Conference and Scientific Sessions

Release Date: 06.22.2012

Presentation Type: Abstracts

Freeman ML, Landolfo CK, Safford RE, Keller CA, Heckman MG, Burger CD.

Mayo Clinic Florida, Jacksonville, Florida. USA

BACKGROUNDNon-invasive assessment of right heart function and hemodynamics in patients with pulmonary arterial hypertension (PAH) is most often performed at rest whereas the symptoms are generally with exertion. We investigated the feasibility of obtaining echocardiographic data that could accurately reflect pulmonary artery pressures (PAP), particularly mean PAP, and right ventricular function during exercise in patients with PAH.

METHODSWe investigated right ventricular function and hemodynamics using echocardiography during symptom-limited exercise in ten consecutive patients that had undergone right heart catheterization (RHC) as part of their clinical evaluation for PAH. We further assessed these measurements for correlation with known predictors of outcome in PAH in an exploratory analysis.

RESULTSWe were able to successfully obtain complete right heart measurements by echocardiography, including mean PAP, in the majority (9/10) of the subjects. One patient had an incomplete tricuspid regurgitation (TR) jet at rest and with exercise. Echocardiographic measurements of pulmonary vascular resistance and tricuspid annular plane systolic excursion during exercise moderately correlated with brain natriuretic peptide level and WHO functional class. TR velocity and mean PAP with exercise moderately correlated with mean PAP and cardiac output by RHC.

CONCLUSIONSExercise echocardiography can provide meaningful data in PAH patients, including measuring mean PAP. The presence of correlations in this small number of patients indicates promising targets for future investigation.