Please use this identifier to cite or link to this item:
http://hdl.handle.net/1942/43066
Title: | Exercise Echocardiography for mPAP/CO Slope Estimation | Authors: | BEKHUIS, Youri VERWERFT, Jan CLAESSEN, Guido |
Issue Date: | 2024 | Publisher: | ELSEVIER SCIENCE INC | Source: | JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 83 (14) , p. e141 -e142 | Abstract: | We read with interest the paper by Gargani et al 1 on the prognostic implications of exercise echocardiog-raphy of the right ventricle and pulmonary circulation. The value of exercise echocardiography for assessing the mean pulmonary artery pressure over cardiac output (mPAP/CO) slope has been a source of conjecture for many years. Particularly, its accuracy and feasibility have been debated, and so far, invasive determination of pulmonary pressures is typically deemed necessary for diagnosing exercise-induced pulmonary hypertension. However, the current study challenges this concept by elegantly demonstrating that noninvasive determination of the mPAP/CO slope, irrespective of its relation to invasive pressures, does provide major diagnostic and prog-nostic information. Acceptable feasibility is another essential requirement for the mPAP/CO slope to become widely adopted in daily practice. Although information regarding feasibility is not provided in the paper, based on the data provided, we could infer that the mPAP/CO slope was obtained in only 720 of 1,356 patients with survival data available. Limited feasibility of mPAP/CO slope estimation was also reported by a previous study, in which tricuspid regurgitation gradients could only be obtained during exercise in 34% of patients. 2 In our experience, the accuracy and feasibility of noninvasive mPAP/CO slope determination can be improved substantially by the use of FI GURE 1 Pulmonary Artery Pressure Measurement Using Colloid Enhancement of the TR Signal Agitated colloid administration (white arrow) improves exercise pressure estimation in a patient without a detectable TR signal. The dotted yellow line represents the echocardiographic estimation of right ventricular systolic pressure. TR ¼ tricuspid regurgitation. | Notes: | Bekhuis, Y (corresponding author), Univ Hosp Leuven, Dept Cardiovasc Dis, Herestr 49, B-3000 Leuven, Belgium. youri.bekhuis@uzleuven.be |
Keywords: | Humans;Exercise;Pulmonary Artery;Hemodynamics;Exercise Test;Echocardiography;Hypertension, Pulmonary | Document URI: | http://hdl.handle.net/1942/43066 | ISSN: | 0735-1097 | e-ISSN: | 1558-3597 | DOI: | 10.1016/j.jacc.2023.12.039 | ISI #: | 001224448200003 | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
2024 - Bekhuis et al. - JACC - Exercise Echocardiography for mPAPCO Slope Estimation.pdf Restricted Access | Published version | 267.07 kB | Adobe PDF | View/Open Request a copy |
JACC_email_attachment_SMC_1702569072_1_YB.pdf Until 2024-10-09 | Peer-reviewed author version | 304.17 kB | Adobe PDF | View/Open Request a copy |
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.