Left ventricular dysfunction in patients with suspected pulmonary arterial hypertension

Area of Science:

• Cardiology
• Pulmonology
• Diagnostic Imaging

Background:

• Pulmonary arterial hypertension (PAH) diagnosis can be challenging.
• Non-invasive tests may not always accurately differentiate PAH from other conditions like left ventricular dysfunction (LVD).

Purpose of the Study:

• To evaluate the diagnostic utility of right heart catheterization (RHC) for pulmonary arterial hypertension (PAH).
• To assess the role of RHC in identifying PAH, especially when non-invasive tests are inconclusive or suggest other pathologies.

Main Methods:

• Retrospective analysis of patients undergoing RHC with suspected PAH.
• Exclusion of patients with severe LVD, abnormal pulmonary function tests, or scintigraphy findings indicative of chronic pulmonary thromboembolism.
• Evaluation of clinical, functional, and hemodynamic data.

Main Results:

• Out of 384 patients, 302 (78.6%) had confirmed pulmonary hypertension (PH).
• Among 218 eligible patients, 18.3% were diagnosed with PH-LVD and 81.7% with PAH.
• Older patients were more likely to have PH-LVD, with significant differences noted between groups.

Conclusions:

• Cardiac catheterization plays a fundamental role in diagnosing PAH.
• RHC is particularly important in older patients where undiagnosed LVD is more prevalent and can confound non-invasive assessments.
• The study underscores the necessity of RHC for accurate PAH diagnosis, especially in complex cases.