A simple, noninvasive test measures survival time in adult pulmonary hypertension

Researchers have developed a simple, noninvasive way to measure right ventricular function in the heart to predict survival of adults who suffer from pulmonary hypertension.

The research appears in the first issue for November 2006 of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.

Paul M. Hassoun, M.D., of the Divisions of Cardiology, Pulmonary and Critical Care Medicine at Johns Hopkins Hospital in Baltimore, and 11 associates studied 63 consecutive patients with pulmonary hypertension. After right heart catheterization, these patients underwent a transthoracic echocardiogram to assess right ventricular performance in the heart.

Study participants were mostly female, white and had an average age of 55. Seventy-five percent (47 patients) met the World Health Organization's group 1 diagnostic classification of pulmonary hypertension.

Pulmonary hypertension involves progressive narrowing of the blood vessels in the lungs, which can lead to death. In 2000, 163,000 patients discharged from U.S. hospitals had been diagnosed with primary pulmonary hypertension. Although the problem is difficult to detect in a routine medical exam, doctors see more rapid clinical deterioration in patients who have the greatest degree of right ventricular dysfunction.

To assess the problem, researchers performed a test called tricuspid annular plane systolic excursion (TAPSE), which measures echocardiographic abnormalities in the tricuspid valve. Located between the heart's right atrium and right ventricle, the valve prevents the backflow of blood as it is pumped from the right atrium to the right ventricle.

"We found that a TAPSE of less than 1.8 cm was associated with a greater ventricular systolic dysfunction, as well as right heart remodeling," said Dr. Hassoun. "In addition, survival estimates at one and two years for those with pulmonary arterial hypertension wer

Contact: Suzy Martin
American Thoracic Society

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