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Advanced Imaging in Pulmonary Hypertension

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Pulmonary Hypertension

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Abstract

Pulmonary hypertension is a pathophysiological state defined as mean pulmonary artery pressure ≥ 25 mmHg at rest determined by right heart catheterization. Various non-invasive imaging modalities have been used to not only establish a tentative diagnosis of pulmonary hypertension but to assess its severity, to identify underlying etiology, to monitor disease progression and response to treatment. Continuous wave Doppler measurements of peak velocity of the tricuspid regurgitant jet is used to determine systolic pulmonary artery pressure non invasively but has various shortcomings when describing the complex right ventricle. Chest radiography may give the first clue to the presence of pulmonary hypertension with information about the cardiac size and pulmonary vasculature. The role of ventilation-perfusion scintigraphy is in the highly sensitive detection of pulmonary embolism which may indicate chronic thromboembolic pulmonary hypertension. Various features of pulmonary hypertension in the main and peripheral pulmonary arteries as well as the lung parenchyma are well visualised by computed tomography. Measures of right ventricular function have been shown to be prognostic in pulmonary hypertension and cardiac magnetic resonance imaging provides accurate information regarding biventricular mass, volume and function. New advances in imaging techniques such as Positron Emission Tomography will give us greater insight into the basic pathobiology of pulmonary vascular remodeling and RV dysfunction.

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Acknowledgment

Echocardiography images provided by Dr. Bouchra Lamia Associate Professor chez CHU-Hôpitaux de Rouen

CXR/CT/VQ and MRI images provided by Dr. Stephen Crawley, Glasgow Royal Infirmary, Glasgow

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Authors and Affiliations

  1. Scottish Pulmonary Vascular Unit, Golden Jubilee National Hospital, Glasgow, UK

    Geeshath Jayasekera MBChB, MRCP

  2. Scottish Pulmonary Vascular Unit, Regional Heart and Lung Centre, Golden Jubilee National Hospital, Agamemnon Street, Glasgow, G12 8DY, UK

    Andrew J. Peacock MPhil, MD

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  1. Geeshath Jayasekera MBChB, MRCP
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  2. Andrew J. Peacock MPhil, MD
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Correspondence to Andrew J. Peacock MPhil, MD .

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Editors and Affiliations

  1. Cardiovascular Medicine Dept, Harvard Medical School Brigham and Women’s Hospital, Boston, Massachusetts, USA

    Bradley A. Maron

  2. Pulmonary & Critical Care Medicine, Stanford University Medical Center, Stanford, California, USA

    Roham T. Zamanian

  3. Pulmonary Critical Care Medicine Dept Cardiovascular Medicine Dept, Brigham and Women's Hospital Harvard Medical School, Boston, Massachusetts, USA

    Aaron B. Waxman

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Jayasekera, G., Peacock, A.J. (2016). Advanced Imaging in Pulmonary Hypertension. In: Maron, B., Zamanian, R., Waxman, A. (eds) Pulmonary Hypertension. Springer, Cham. https://doi.org/10.1007/978-3-319-23594-3_12

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  • DOI: https://doi.org/10.1007/978-3-319-23594-3_12

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