Cardiac Catheterization and Hemodynamics in a Multicenter Cohort of Children with Pulmonary Hypertension.
Rationale: Hemodynamic assessments direct care among children with pulmonary hypertension, yet the use of cardiac catheterization is highly variable, which could impact patient care and research. Objectives: We analyzed hemodynamic findings from right heart catheterization (RHC) and left heart cathe...
| Publicado en: | Annals of the American Thoracic Society Vol. 19; no. 6; pp. 1000 - 1013 |
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| Autores principales: | , , , , , , , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Oxford University Press / USA
Jun2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=157267024&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 157267024 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 23296933 FUCV jtl: Annals of the American Thoracic Society issn: 23296933 maglogo: N pubinfo: dt: Jun2022 vid: 19 iid: 6 pid: 622 pub: Oxford University Press / USA artinfo: ui: 157267024 157267024 NLM35049414 157267024 10.1513/AnnalsATS.202108-998OC NLM35049414 157267024 ppf: 1000 ppct: 13 formats: tig: atl: Cardiac Catheterization and Hemodynamics in a Multicenter Cohort of Children with Pulmonary Hypertension. aug: au: Rosenzweig, Erika B. Bates, Angela Mullen, Mary P. Abman, Steven H. Austin, Eric D. Everett, Allen Fineman, Jeffrey Feinstein, Jeffery Hopper, Rachel K. Kinsella, John P. Krishnan, Usha S. Minmin Lu Mandl, Kenneth D. Raj, J. Usha Varghese, Nidhy Yung, Delphine Handler, Stephanie S. Sleeper, Lynn A. Lu, Minmin affil: Division of Pediatric Cardiology, Department of Pediatrics, Columbia University Irving Medical Center, New York, New York. sug: subj: Hypertension, Pulmonary Female Heart Catheterization Adverse Effects Pulmonary Wedge Pressure Child Hemodynamics Vasodilator Agents Infant, Newborn Prospective Studies Comparative Studies Multicenter Studies Evaluation Research Validation Studies Funding Source Human Child: 6-12 years Infant, Newborn: birth-1 month Female ab: Rationale: Hemodynamic assessments direct care among children with pulmonary hypertension, yet the use of cardiac catheterization is highly variable, which could impact patient care and research. Objectives: We analyzed hemodynamic findings from right heart catheterization (RHC) and left heart catheterization and acute vasodilator testing (AVT) and the safety of catheterization in children with World Symposium on Pulmonary Hypertension (WSPH) group 1 and 3 subtypes in a large multicenter North American cohort. Methods: Of 1,475 children enrolled in the Pediatric Pulmonary Hypertension Network Registry (2014-2020), there were 1,383 group 1 and 3 patients, of whom 671 (48.5%) underwent RHC at diagnosis and were included for analysis. Results: Compared with those without diagnostic RHC, these children were older, less likely to be an infant or preterm, more often female, treated with targeted pulmonary hypertension medications at diagnosis, and had advanced World Health Organization functional class. Catheterization was performed without a difference in complication rates between WSPH groups. Pulmonary capillary wedge pressure was well correlated with left ventricular end-diastolic pressure and left atrial pressures. Results of AVT using three different methods were comparable; positive AVT results were observed in 8.0-11.8% of subjects, did not differ between WSPH groups 1 and 3, and were not associated with freedom from the composite endpoint of lung transplantation or death during follow-up. Conclusions: In a large pediatric pulmonary hypertension cohort, diagnostic RHC with or without left heart catheterization in WSPH group 1 and 3 patients was performed safely at experienced pediatric pulmonary hypertension centers. Hemodynamic differences were noted between group 1 and 3 subjects. Higher mean pulmonary arterial pressure and mean pulmonary arterial pressure/mean systemic arterial pressure ratio were associated with a higher risk of death/transplantation. Findings suggest overall safety and potential value of RHC as a standard diagnostic approach to guide pulmonary hypertension management in children. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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