medigraphic.com
ISSN 2594-1526 (Electronic)
Antes Revista del Instituto Nacional de Enfermedades Respiratorias

 Ver anteriores al 2010

2020, Number 3

<< Back Next >>

Neumol Cir Torax 2020; 79 (3)

Bidimensional echocardiographic findings in patients with suspected pulmonary hypertension. A 5-year experience in the southeast of Mexico

Manjarrez-Martín DA, Vázquez-López S, Rodríguez-Morales A, Torre-Bouscoulet L, Cortes-Telles A

Language: Spanish
References: 39
Page: 151-158
PDF size: 306.00 Kb.


ABSTRACT

Introduction: Two-dimensional transthoracic echocardiogram is a portable, non-invasive tool, with greater accessibility than the right heart catheterization and provides multiple reliable parameters regarding pulmonary hemodynamics; however, the available information supporting the use of two-dimensional transthoracic echocardiogram in subjects with suspected HP is very limited. Material and methods: This is a cross-sectional analysis of a cohort study that has prospectively and consecutively included all subjects with suspected pulmonary hypertension (different from group 2), which have been evaluated in the Respiratory and Thoracic Surgery Unit of the Hospital Regional de Alta Especialidad de la Península de Yucatán, México. Results: The report includes 52 patients with a median age of 52 years (IQR 31-65) and 78% were female. Among the possible cases attributable to group 1, the main subgroup was the one related to congenital heart diseases. Among the echocardiographic variables that may allow better screening of patients with suspected HP group 1 were: TAPSE (OR 0.82, 95% CI 0.69-0.96) and PsAP (OR 1.08, 95% CI 1.04-1.14). Conclusion: In our setting, the use of ECOTT is acceptable in the evaluation of cases with suspected HP, particularly when evaluating women with a history of congenital heart disease.


REFERENCES

  1. Badesch DB, Champion HC, Sanchez MA, Hoeper MM, Loyd JE, Manes A, et al. Diagnosis and assessment of pulmonary arterial hypertension. J Am Coll Cardiol. 2009;54(1 Suppl):S55-S66. https://doi.org/10.1016/j.jacc.2009.04.011

  2. Galiè N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A, et al. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). Eur Respir J. 2015;46(4):903-975. https://doi.org/10.1183/13993003.01032-2015

  3. Klinger JR, Elliott CG, Levine DJ, Bossone E, Duvall L, Fagan K, et al. Therapy for pulmonary arterial hypertension in adults: Update of the CHEST Guideline and Expert Panel Report. Chest. 2019;155(3):565-586. https://doi.org/10.1016/j.chest.2018.11.030

  4. McGoon MD, Benza RL, Escribano-Subias P, Jiang X, Miller DP, Peacock AJ, et al. Pulmonary arterial hypertension: epidemiology and registries. J Am Coll Cardiol. 2013;62(25 Suppl):D51-D59. https://doi.org/10.1016/j.jacc.2013.10.023

  5. Badesch DB, Raskob GE, Elliott CG, Krichman AM, Farber HW, Frost AE, et al. Pulmonary arterial hypertension: baseline characteristics from the REVEAL registry. Chest. 2010;137(2):376-387. https://doi.org/10.1378/chest.09-1140

  6. Humbert M, Sitbon O, Chaouat A, Bertocchi M, Habib G, Gressin V, et al. Pulmonary arterial hypertension in France: results from a national registry. Am J Respir Crit Care Med. 2006; 173(9):1023-1030. https://doi.org/10.1164/rccm.200510-1668oc

  7. Alves JL Jr, Gavilanes F, Jardim C, Fernandes CJCDS, Morinaga LTK, Dias B, et al. Pulmonary arterial hypertension in the southern hemisphere: results from a registry of incident Brazilian cases. Chest. 2015;147(2):495-501. https://doi.org/10.1378/chest.14-1036

  8. Pulido T, Adzerikho I, Channick RN, Delcroix M, Galiè N, Ghofrani HA, et al. Macitentan and morbidity and mortality in pulmonary arterial hypertension. N Engl J Med. 2013;369(9):809-818. https://doi.org/10.1056/nejmoa1213917

  9. Al-Naamani N, Espitia HG, Velazquez-Moreno H, Macuil-Chazaro B, Serrano-Lopez A, Vega-Barrientos RS, et al. Chronic thromboembolic pulmonary hypertension: Experience from a single center in Mexico. Lung. 2016;194(2):315-323. https://doi.org/10.1007/s00408-016-9842-y

  10. Calderon-Colmenero J, Sandoval Zárate J, Beltrán Gámez M. [Pulmonary hypertension associated with congenital heart disease and Eisenmenger syndrome]. Arch Cardiol Mex. 2015;85(1):32-49. https://doi.org/10.1016/j.acmx.2014.11.008

  11. Mehta S, Sastry BKS, Souza R, Torbicki A, Ghofrani HA, Channick RN, et al. Macitentan improves health-related quality of life for patients with pulmonary arterial hypertension: Results from the randomized controlled SERAPHIN trial. Chest. 2017;151(1):106-118. https://doi.org/10.1016/j.chest.2016.08.1473

  12. Hoeper MM, Bogaard HJ, Condliffe R, Frantz R, Khanna D, Kurzyna M, et al. Definitions and diagnosis of pulmonary hypertension. J Am Coll Cardiol. 2013;62(25 Suppl):D42-D50. https://doi.org/10.1016/j.jacc.2013.10.032

  13. Denis M, Morales-Blanhir JE, Rosas-Romero Mde J, Martínez-Ramírez C. [Relevance of society’s participation in medicine. The case of pulmonary hypertension in Latin America]. Arch Cardiol Mex. 2011;81(1):68-69.

  14. Goerne H, Batra K, Rajiah P. Imaging of pulmonary hypertension: an update. Cardiovasc Diagn Ther. 2018;8(3):279-296. https://doi.org/10.21037/cdt.2018.01.10

  15. Cordina RL, Playford D, Lang I, Celermajer DS. State-of-the-Art Review: Echocardiography in pulmonary hypertension. Heart Lung Circ 2019;28(9): 1351-1364. https://doi.org/10.1016/j.hlc.2019.03.003

  16. Shelburne NJ, Parikh KS, Chiswell K, Shaw LK, Sivak J, Arges K, et al. Echocardiographic assessment of right ventricular function and response to therapy in pulmonary arterial hypertension. Am J Cardiol. 2019;124(8):1298-1304. https://doi.org/10.1016/j.amjcard.2019.07.026

  17. Goldberg AB, Mazur W, Kalra DK. Pulmonary hypertension: diagnosis, imaging techniques, and novel therapies. Cardiovasc Diagn Ther. 2017;7(4):405-417. https://doi.org/10.21037/cdt.2017.04.11

  18. Li Y, Wang Y, Li H, Zhu W, Meng X, Lu X. Evaluation of the hemodynamics and right ventricular function in pulmonary hypertension by echocardiography compared with right-sided heart catheterization. Exp Ther Med. 2017;14(4): 3616-3622. https://doi.org/10.3892/etm.2017.4953

  19. Stenton C. The MRC breathlessness scale. Occup Med (Lond) 2008;58(3): 226-227. https://doi.org/10.1093/occmed/kqm162

  20. Taichman DB, McGoon MD, Harhay MO, Archer-Chicko Ch, Sager JS, Murugappan M, et al. Wide variation in clinicians’ assessment of New York Heart Association/World Health Organization functional class in patients with pulmonary arterial hypertension. Mayo Clin Proc. 2009;84(7):586-592. https://doi.org/10.1016/s0025-6196(11)60747-7

  21. ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166(1):111-117. https://doi.org/10.1164/ajrccm.166.1.at1102

  22. Graham BL, Steenbruggen I, Miller MR, Barjaktarevic IZ, Cooper BG, Hall GL, et al. Standardization of spirometry 2019 update. An Official American Thoracic Society and European Respiratory Society Technical Statement. Am J Respir Crit Care Med. 2019;200(8):e70-e88. https://doi.org/10.1164/rccm.201908-1590st

  23. Duffels MG, Engelfriet PM, Berger RM, van Loon RLE, Hoendermis E, Vriend JWJ, et al. Pulmonary arterial hypertension in congenital heart disease: an epidemiologic perspective from a Dutch registry. Int J Cardiol. 2007;120(2):198-204. https://doi.org/10.1016/j.ijcard.2006.09.017

  24. Engelfriet PM, Duffels MG, Möller T, Boersma E, Tijssen JGP, Thaulow E, et al. Pulmonary arterial hypertension in adults born with a heart septal defect: the Euro Heart Survey on adult congenital heart disease. Heart. 2007;93(6):682-687. https://doi.org/10.1136/hrt.2006.098848

  25. Thenappan T, Shah SJ, Rich S, Gomberg-Maitland M. A USA-based registry for pulmonary arterial hypertension: 1982-2006. Eur Respir J. 2007;30(6):1103-1110. https://doi.org/10.1183/09031936.00042107

  26. Baltaxe E, Zarante I. [Prevalence of congenital heart disease in 44,985 newborns in Colombia]. Arch Cardiol Mex. 2006;76(3):263-268.

  27. Kapoor R, Gupta S. Prevalence of congenital heart disease, Kanpur, India. Indian Pediatr. 2008;45(4):309-311.

  28. Mendieta-Alcántara GG, Santiago-Alcántara E, Mendieta-Zerón H, Dorantes-Pina R, Ortiz de Zárate-Alarcón G, Otero-Ojeda GA. [Incidence of congenital heart disease and factors associated with mortality in children born in two Hospitals in the State of Mexico]. Gac Med Mex. 2013;149(6):617-623.

  29. Torres-Cosme JL, Rolón-Porras C, Aguinaga-Ríos M, Acosta-Granado PM, Reyes-Muñoz E, Murguía-Peniche T. Mortality from congenital heart disease in Mexico: A problem on the rise. PLoS One. 2016;11(3):e0150422. https://doi.org/10.1371/journal.pone.0150422

  30. Boucly A, Weatherald J, Savale L, Jaïs X, Cottin V, Prevot G, et al. Risk assessment, prognosis and guideline implementation in pulmonary arterial hypertension. Eur Respir J. 2017;50(2):1700889. https://doi.org/10.1183/13993003.00889-2017

  31. Leuchte HH, El Nounou M, Tuerpe JC, Hartmann B, Baumgartner RA, Vogeser M, et al. N-terminal pro-brain natriuretic peptide and renal insufficiency as predictors of mortality in pulmonary hypertension. Chest. 2007;131(2):402-409. https://doi.org/10.1378/chest.06-1758

  32. de Bold AJ, Borenstein HB, Veress AT, Sonnenberg H. A rapid and potent natriuretic response to intravenous injection of atrial myocardial extract in rats. Life Sci. 1981;28(1):89-94. https://doi.org/10.1016/0024-3205(81)90370-2

  33. Salerno D, Marik PE. Brain natriuretic peptide measurement in pulmonary medicine. Respir Med. 2011;105(12):1770-1775. https://doi.org/10.1016/j.rmed.2011.07.013

  34. Al-Naamani N, Palevsky HI, Lederer DJ, Horn EM, Mathai SC, Roberts KE, et al. Prognostic significance of biomarkers in pulmonary arterial hypertension. Ann Am Thorac Soc. 2016;13(1): 25-30. https://doi.org/10.1513/annalsats.201508-543oc

  35. Low AT, Medford AR, Millar AB, Tulloh RM. Lung function in pulmonary hypertension. Respir Med. 2015;109(10):1244-1249. https://doi.org/10.1016/j.rmed.2015.05.022

  36. Jing ZC, Xu XQ, Badesch DB, Jiang X, Wu Y, Liu JM, et al. Pulmonary function testing in patients with pulmonary arterial hypertension. Respir Med. 2009;103(8):1136-1142. https://doi.org/10.1016/j.rmed.2009.03.009

  37. Escribano PM, Sánchez MA, de Atauri MJ, Frade JP, García IM. [Lung function testing in patients with pulmonary arterial hypertension]. Arch Bronconeumol. 2005;41(7):380-384. https://doi.org/10.1016/s1579-2129(06)60245-0

  38. Farha S, Laskowski D, George D, Park MM, Tang WHW, Dweik RA, et al. Loss of alveolar membrane diffusing capacity and pulmonary capillary blood volume in pulmonary arterial hypertension. Respir Res. 2013;14(1):6. https://doi.org/10.1186/1465-9921-14-6

  39. Badagliacca R, Papa S, Valli G, Pezzuto B, Poscia R, Manzi G, et al. Echocardiography combined with cardiopulmonary exercise testing for the prediction of outcome in idiopathic pulmonary arterial hypertension. Chest. 2016;150(6):1313-1322. https://doi.org/10.1016/j.chest.2016.07.036




2020     |     www.medigraphic.com