Pulmonary Arterial Hypertension: The Key Role of Echocardiography

• Published in: Echocardiography (Mount Kisco, N.Y.) Vol. 32; no. S1; pp. S23 - S37
• Main Authors: D'Alto, Michele, Romeo, Emanuele, Argiento, Paola, Di Salvo, Giovanni, Badagliacca, Roberto, Cirillo, Anna P., Kaemmerer, Harald, Bossone, Eduardo, Naeije, Robert
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01-01-2015
• Subjects: Cardiac Catheterization; differential diagnosis; echocardiography; Echocardiography, Three-Dimensional - methods; Female; Humans; Hypertension, Pulmonary - diagnosis; Hypertension, Pulmonary - diagnostic imaging; Male; Mass Screening - methods; Monitoring, Physiologic - methods; new technologies; Prognosis; Pulmonary Circulation - physiology; pulmonary hypertension; Pulmonary Wedge Pressure - physiology; screening; Sensitivity and Specificity; Severity of Illness Index; Ventricular Dysfunction, Right - diagnostic imaging; Ventricular Dysfunction, Right - physiopathology; Ventricular Function, Right; new technologies; differential diagnosis; screening; prognosis; pulmonary hypertension; echocardiography
• ISSN: 0742-2822; 1540-8175
• DOI: 10.1111/echo.12283

Echocardiography is a key screening tool in the diagnostic algorithm of pulmonary arterial hypertension (PAH). It provides an estimate of right ventricular function and pulmonary artery pressure, either at rest or during exercise, and is useful in ruling out secondary causes of pulmonary hypertension (PH) such as left heart disease or congenital heart disease. Several studies have showed that echocardiography is insufficiently precise as single tool for the ultimate diagnosis of PH respect to the right heart catheterization, considered the gold standard technique. Echocardiography is valuable in assessing prognosis and treatment options, monitoring the efficacy of specific therapeutic interventions, and detecting the preclinical stages of disease. The ideal imaging modality for accurate noninvasive assessment of the right heart should be accurate and precise, not influenced by loading conditions, routinely practicable and easily repeatable. For all such reasons and considering that PAH is a rare and severe condition, a complete noninvasive assessment of right heart function requires a deep knowledge of the disease and a multimodality approach.