Evaluation of pulmonary hypertension in heart transplant candidates.

Maria Eugenia Natale, Ileana L. Pina

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Assessment of the pulmonary circulation and right ventricular function is a cornerstone in the evaluation of the patient as a potential heart transplant recipient. The importance of pulmonary hypertension is linked to outcomes in the posttransplant period. Preoperative pulmonary vascular resistance is an independent risk factor for early death after heart transplantation. Pulmonary hypertension can be classified as reversible, or irreversible if not rapidly responsive to pharmacologic maneuvers. However, in most patients, the major component is likely to reverse with vasodilators, because of the central role played by the endothelium in the control of pulmonary vascular tone. To discriminate between patients with reversible and irreversible pulmonary hypertension, provocative therapies are used, and baseline and the postprovocation hemodynamic parameters are measured. To date, there is no reliable hemodynamic threshold beyond which right ventricular failure is certain to occur, nor are there values below which right ventricular failure is always avoidable. Because of this uncertainty, it becomes clear that only through careful preoperative assessment can this life-threatening condition be recognized preoperatively and, hence, managed in the posttransplant recovery period.

Original languageEnglish (US)
Pages (from-to)136-140
Number of pages5
JournalCurrent Opinion in Cardiology
Volume18
Issue number2
StatePublished - Mar 2003
Externally publishedYes

Fingerprint

Pulmonary Hypertension
Transplants
Hemodynamics
Right Ventricular Function
Pulmonary Circulation
Heart Transplantation
Vasodilator Agents
Vascular Resistance
Uncertainty
Endothelium
Blood Vessels
Lung
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Evaluation of pulmonary hypertension in heart transplant candidates. / Natale, Maria Eugenia; Pina, Ileana L.

In: Current Opinion in Cardiology, Vol. 18, No. 2, 03.2003, p. 136-140.

Research output: Contribution to journalArticle

Natale, Maria Eugenia ; Pina, Ileana L. / Evaluation of pulmonary hypertension in heart transplant candidates. In: Current Opinion in Cardiology. 2003 ; Vol. 18, No. 2. pp. 136-140.
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