Related Experiment Videos
Primary pulmonary hypertension. Vascular structure, morphometry, and responsiveness to vasodilator agents.
H I Palevsky1, B L Schloo, G G Pietra
1Department of Medicine, University of Pennsylvania, Philadelphia 19104-4283.
Circulation
|November 1, 1989
Summary
Pulmonary hypertension treatment varies. Quantitative lung biopsy analysis, not qualitative, predicts patient response to vasodilators and clinical outcomes in primary pulmonary hypertension.
Area of Science:
- Cardiology
- Pulmonology
- Pathology
Background:
- Pharmacologic treatment for pulmonary hypertension shows inconsistent success.
- Pulmonary vascular lesion variability may explain unpredictable treatment responses.
Purpose of the Study:
- To investigate the relationship between pulmonary resistance vessel structure and vasodilator response in primary pulmonary hypertension.
Main Methods:
- 19 patients with unexplained pulmonary hypertension underwent hemodynamic measurements and vasodilator testing.
- Lung biopsy specimens were analyzed qualitatively and quantitatively (morphometrics).
- Histologic findings were correlated with hemodynamic response and clinical outcomes.
Main Results:
- Only 4 of 19 patients responded to vasodilators; responses varied significantly.
- Qualitative histology did not predict vasodilator response.
- Quantitative morphometric analysis, specifically intimal area (>18%), predicted poor outcomes with 85% accuracy.
Conclusions:
- Pulmonary vascular structure, assessed quantitatively, is crucial for predicting vasodilator response and clinical course in primary pulmonary hypertension.
- Morphometric analysis of lung biopsies offers predictive value for patient management.