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Assessment of the state of the cardiorespiratory system in pulmonary hypertension associated with congenital heart disease

Authors: Glushko L.A., Shmalts A.A.

Company: 1 Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation
2 Russian Medical Academy of Continuing Professional Education, Moscow, Russian Federation

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Type:  Reviews


DOI: https://doi.org/10.24022/1997-3187-2021-15-2-167-179

For citation: Glushko L.A., Shmalts A.A. Assessment of the state of the cardiorespiratory system in pulmonary hypertension associated with congenital heart disease. Creative Cardiology. 2021; 15 (2): 167–79 (in Russ.). DOI: 10.24022/1997-3187-2021-15-2-167-179

Received / Accepted:  23.04.2021 / 23.06.2021

Keywords: pulmonary hypertension congenital heart disease cardiopulmonary exercise testing 6-minute walk test lung function tests lung diffusion capacity test end-expiratory partial pressure of carbon dioxide

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Abstract

Pulmonary hypertension (PH) is characterized by an increase in mean pulmonary artery (PA) pressure above 25 mm Hg. PH is common in adults with congenital heart disease (CHD) and significantly affects morbidity and mortality. Careful screening of all CHD patients is critical to identify patients who develop PH and who may benefit from further investigations, including cardiac catheterization and initiation of PAH-specific therapy. The diagnosis of PH is made in the catheterization laboratory by a complete invasive hemodynamic assessment using a vasodilator. Screening for PH is currently done with routine echocardiography. However, with echocardiography, data errors are possible due to the fact that systolic pressure in the right ventricle is estimated by the speed of the tricuspid regurgitation stream, and the diastolic pressure of the pulmonary artery – by the speed of the regurgitation stream of the pulmonary artery valve, additional stenosis of the pulmonary artery is possible. The state of the cardiorespiratory system in patients with CHD complicated by PH can be assessed using a 6-minute walk test and a cardiopulmonary exercise test. Lung function tests and lung diffusion testing may provide additional information.

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About Authors

  • Lyudmila A. Glushko, Cand. Med. Sci., Head of Pulmonary Tests and Gas Exchange Monitoring Group, Cardiologist, Functional Diagnostician, Associate Professor; ORCID
  • Anton A. Shmalts, Dr. Med. Sci., Leading Researcher, Associate Professor; ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


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