Imaging in Pulmonary Hypertension

• Published in: JACC. Cardiovascular imaging Vol. 3; no. 12; pp. 1287 - 1295
• Main Authors: Lang, Irene M., MD, Plank, Christina, MD, Sadushi-Kolici, Roela, MD, Jakowitsch, Johannes, PhD, Klepetko, Walter, MD, Maurer, Gerald, MD
• Format: Journal Article
• Language: English
• Published: United States 01.12.2010
• Subjects: Cardiovascular; Diagnostic Imaging - methods; Hemodynamics; Humans; Hypertension, Pulmonary - diagnosis; Hypertension, Pulmonary - physiopathology; Practice Guidelines as Topic; Predictive Value of Tests; Prognosis; Ventricular Function, Right; computed tomography; RV; right ventricular; pulmonary hypertension; CMR; CT; right ventricle; perfusion scintigraphy; PAH; V/Q; radionuclide ventilation-perfusion scanning; pulmonary vascular resistance; cardiac magnetic resonance; pulmonary arterial hypertension
• ISSN: 1936-878X; 1876-7591
• DOI: 10.1016/j.jcmg.2010.09.013

Pulmonary hypertension is defined as an increase in mean pulmonary arterial pressure ≥25 mm Hg at rest and occurs in a majority of patients with heart failure. Diagnostic imaging targets the right ventricle and the pulmonary vasculature. Although echocardiography is cost-effective for screening and follow-up, right heart catheterization is still mandatory to differentiate pre- from post-capillary disease and to directly measure pressure and flow. An important goal is to rule out chronic thromboembolic pulmonary hypertension. This diagnostic step can be achieved by perfusion scintigraphy, whereas computed tomography and cardiac magnetic resonance have become indispensable ancillary methods for the diagnostic allocation to other World Health Organization subtypes of pulmonary hypertension.