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Mildly elevated pulmonary artery systolic pressure on echocardiography: bridging the gap in current guidelines
The Lancet Respiratory Medicine ( IF 38.7 ) Pub Date : 2021-07-21 , DOI: 10.1016/s2213-2600(21)00072-2
Matthew Jankowich 1 , Bradley A Maron 2 , Gaurav Choudhary 1
Affiliation  

Pulmonary hypertension is associated with increased morbidity and mortality, and growing evidence suggests that even mild elevations in pulmonary artery pressure estimated with echocardiography are linked to increased mortality. In healthy individuals who undergo right heart catheterisation, the average pulmonary artery systolic pressure ranges from 17 mm Hg to 25 mm Hg; on echocardiography, estimated pulmonary artery systolic pressure of more than 30 mm Hg is outside the normal range for most healthy individuals. Increased pulmonary artery systolic pressure (>30 mm Hg) is reported on more than 40% of clinically indicated echocardiograms, often in the presence of metabolic and cardiopulmonary comorbidities, and is associated with a 5-year mortality of 25–40%. However, current guidelines do not sufficiently highlight risk and risk-reduction approaches for the sizable patient population with elevated pulmonary artery pressure who do not have underlying severe pulmonary vascular disease such as pulmonary arterial hypertension. Increased awareness of this frequently reported high-risk echocardiographic finding, and multidisciplinary risk-reduction approaches for patients with metabolic and cardiopulmonary comorbidities and elevated pulmonary artery pressure, are urgently needed.



中文翻译:

超声心动图显示肺动脉收缩压轻度升高:弥合当前指南的差距

肺动脉高压与发病率和死亡率增加有关,越来越多的证据表明,即使通过超声心动图估计的肺动脉压轻度升高也与死亡率增加有关。在接受右心导管插入术的健康个体中,平均肺动脉收缩压范围为 17 mm Hg 至 25 mm Hg;在超声心动图上,估计的肺动脉收缩压超过 30 毫米汞柱超出了大多数健康个体的正常范围。超过 40% 的临床超声心动图报告显示肺动脉收缩压升高(>30 mm Hg),通常存在代谢和心肺合并症,并且与 25-40% 的 5 年死亡率相关。然而,目前的指南没有充分强调大量肺动脉压升高且没有潜在严重肺血管疾病(如肺动脉高压)的患者群体的风险和降低风险的方法。迫切需要提高对这种经常报告的高危超声心动图发现的认识,并为患有代谢和心肺合并症以及肺动脉压升高的患者采取多学科降低风险的方法。

更新日期:2021-09-29
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