Stressing the cardiopulmonary vascular system: the role of echocardiography

The cardiopulmonary vascular system represents a key determinant of prognosis in several cardiorespiratory diseases. Although right heart catheterization is considered the gold standard for assessing pulmonary hemodynamics, a comprehensive noninvasive evaluation including left and right ventricular...

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Hauptverfasser: Rudski, Lawrence G. (VerfasserIn) , Grünig, Ekkehard (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 21 March 2018
In: Journal of the American Society of Echocardiography
Year: 2018, Jahrgang: 31, Heft: 5, Pages: 527-550.e11
ISSN:1097-6795
DOI:10.1016/j.echo.2018.01.002
Online-Zugang:Verlag, Volltext: https://doi.org/10.1016/j.echo.2018.01.002
Verlag, Volltext: http://www.sciencedirect.com/science/article/pii/S0894731718300026
Volltext
Verfasserangaben:Lawrence G. Rudski, MD, Luna Gargani, MD, PhD, William F. Armstrong, MD, PhD, Patrizio Lancellotti, MD, PhD, Steven J. Lester, MD, Ekkehard Grünig, MD, Michele D’Alto, MD, PhD, Meriam Aström Aneq, MD, PhD, Francesco Ferrara, MD, PhD, Rajeev Saggar, MD, Rajan Saggar, MD, Robert Naeije, MD, PhD, Eugenio Picano, MD, PhD, Nelson B. Schiller, MD, and Eduardo Bossone, MD, PhD, FCCP, FESC, FACC

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520 |a The cardiopulmonary vascular system represents a key determinant of prognosis in several cardiorespiratory diseases. Although right heart catheterization is considered the gold standard for assessing pulmonary hemodynamics, a comprehensive noninvasive evaluation including left and right ventricular reserve and function and cardiopulmonary interactions remains highly attractive. Stress echocardiography is crucial in the evaluation of many cardiac conditions, typically coronary artery disease but also heart failure and valvular heart disease. In stress echocardiographic applications beyond coronary artery disease, the assessment of the cardiopulmonary vascular system is a cornerstone. The possibility of coupling the left and right ventricles with the pulmonary circuit during stress can provide significant insight into cardiopulmonary physiology in healthy and diseased subjects, can support the diagnosis of the etiology of pulmonary hypertension and other conditions, and can offer valuable prognostic information. In this state-of-the-art document, the topic of stress echocardiography applied to the cardiopulmonary vascular system is thoroughly addressed, from pathophysiology to different stress modalities and echocardiographic parameters, from clinical applications to limitations and future directions. 
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