Role of right heart catheterization in diagnosis of pulmonary arterial hypertension

Abstract

Background
Pulmonary hypertension (PH) presumably has an impact on 1% or less of the world’s population. Right Heart Catheterization (RHC) is essential for determining PH problems. RHC determines prognosis and offers helpful information on the degree of hemodynamic impairment. Therefore, this comparative study was carried out to determine the diagnostic role, pitfalls associated, and complications encountered during RHC in suspected cases of PAH and chronic thromboembolic pulmonary hypertension (CTEPH).


Methods
The observational cohort study was conducted on 75 patients with clinical suspicion of PH and CTEPH. All patients were subjected to full history taking, ECG, Echocardiography, and radiological investigations including Chest radiography (CXR), high-resolution computed tomography (HRCT), and computed tomography (CT) pulmonary angiography.


Results
The mean pulmonary artery mean pressure (PAMP) was 46.05 ± 9.631 mmHg, the mean Pulmonary artery dilatation (PAD) was 30.04 ± 1.082 mm the mean ejection fraction (EF%) was 63.87%, the mean right ventricular diameter was 45.83 ± 0.444 mm. The mean pulmonary artery wedge pressure (PAWP) was 10.91 ± 2.303 mmHg, and the mean cardiac output (CO) was 4.00 ± 0.773 L/min mean cardiac index (CI) was 1.94 ± 0.416 L/min/m2. Doppler echocardiographic estimated pulmonary artery systolic pressure (DE-ePASP) and estimated pulmonary, artery, end-diastolic pressure (ePADP) significantly positively correlated with RHC-PASP (P < 0.001) and mean DE-ePAP significantly positively Correlated with mean RHC-PAP (P < 0.001).


Conclusions
RHC is still the only method that can completely and accurately diagnose PAH. however, the combination between right cardiac catheterization and echocardiography provides a more accurate diagnosis of the diseases and their complications.