In this abstract session at ESC 2009, the excellent work of five European expert groups in pulmonary hypertension-specific-imaging had been chosen from several hundred submitted abstracts for presentation.
Dr Lindgren from Gothenborg described a simple and comprehensive echocardiographic method allowing a non-invasive estimation of pulmonary arterial resistance, a parameter that can only be assessed invasively. The pressure difference between the pressure derived from the maximal tricuspid regurgitant flow and the flow at the time of the maximal pulmonary ejection velocity reflects the pressure increase that results from pulmonary vascular obstruction, an old observation exploited new. In a study of over 1000 patients with pulmonary hypertension, Dr Grapsa from Hammersmith Hospital in London reported the degree of left ventricular filling impairment as one of the key parameters predicting survival. In another paper she illustrated 3D echo as a promising tool in estimating right ventricular mass and volumes, with a degree of accuracy approaching that of MRI. However, Dr Van Der Zwaan from Rotterdam pointed out in a similar analysis that in congenital heart disease MRI remains the primary tool to assess right ventricular function because of the complexity and unpredictability of right ventricular shape in these conditions. The importance of right ventricular function was reiterated by a study presented by Dr Selimovic from Gothenborg in which a decline of right ventricular ejection fraction under exercise was illustrated in patients with severe functional compromise due to end-stage pre-transplant cardiopulmonary disease. Dr Argiento showed a study she had accomplished at the cardiopulmonary laboratory at the Erasmus University in Brussels under the leadership of Robert Naeije in which exercise stress echocardiography in healthy volunteers disclosed an approximately linear physiological pressure flow relationship with an average incremental resistance of 1 mmHg/L/min.
These observations are important and lay the grounds for a contemporary standardization of normal cardiopulmonary function under exercise.
New echocardiographic insights into pulmonary arterial hypertension
This congress report accompanies a presentation given at the ESC Congress 2009. Written by the author himself/herself, this report does not necessarily reflect the opinion of the European Society of Cardiology.
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