Document Detail

Differentiating pulmonary arterial and pulmonary venous hypertension and the implications for therapy.
MedLine Citation:
PMID:  21091615     Owner:  NLM     Status:  In-Process    
Pulmonary arterial and pulmonary venous hypertension develop from distinctly different etiologies. Pulmonary arterial hypertension (PAH), or Group 1 pulmonary hypertension (PH), is a precapillary PH that arises idiopathically or as the result of a divergent array of causes, including connective tissue disease. Pulmonary venous hypertension (PVH), or Group 2 PH, primarily manifests as a postcapillary PH in the setting of left heart failure or valvular disease. A subset of PVH patients, however, develop a reactive precapillary component of PH that mimics PAH. These patients can be misdiagnosed as having Group 1 PH by 2-dimensional echocardiography and are sometimes treated as such, which leads to exacerbation of heart failure. Therefore, 2-dimensional or Doppler echocardiography alone cannot be used to differentiate between these two classifications of PH. This highlights the need for right heart catheterization in the clinical assessment and diagnostic work-up of PH. The combination of imaging and invasive hemodynamic assessment by right heart catheterization provides the best diagnostic approach to ensure proper delineation of pulmonary arterial and pulmonary venous hypertension, and in turn leads to appropriate treatment.
Sina Dadfarmay; Robert Berkowitz; Bernard Kim; Rama Bindu Manchikalapudi
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Publication Detail:
Type:  Journal Article     Date:  2010-10-21
Journal Detail:
Title:  Congestive heart failure (Greenwich, Conn.)     Volume:  16     ISSN:  1751-7133     ISO Abbreviation:  Congest Heart Fail     Publication Date:    2010 Nov-Dec
Date Detail:
Created Date:  2010-11-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9714174     Medline TA:  Congest Heart Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  287-91     Citation Subset:  IM    
Copyright Information:
© 2010 Wiley Periodicals, Inc.
Heart Failure and Pulmonary Hypertension Program, Heart and Vascular Center, Hackensack University Medical Center, Hackensack, NJ 07601, USA.
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