Hjärtats hemodynamik vid pulmonell hypertension i vila och under stress

Projektbeskrivning

Under lång tid var invasiv tryckmätning den metod som kunde värdera hjärtats hemodynamiska arbete. Med denna metod bestämdes tryck och flöden varvid resistans och tryckgradienter kunde beräknas. På senare tid har Doppler ekokardiografi ersatt denna invasiva metod och då allt som oftast på ett bra sätt. Tyvärr finns det fortfarande vissa aspekter av hemodynamik som är svåra att indirekt skatta med ekokardiografi, varför förbättringsutrymme finns. Dessutom finns ett värde att belasta patienter då symptom oftast endast kommer under arbete och detta får anses än mer komplicerat med ekokardiografi. Detta är dåligt utvärderat mätt både med invasiv tryckmätning och ekokardiografi. Därför har vi under en tid närmare kartlagt detta med användande av både hjärtkateterisering och ekokardiografi, och i många fall samtidigt.

Egna publikationer i ämnet

1: Henein MY, Tossavainen E, A'roch R, Söderberg S, Lindqvist P. Can Doppler echocardiography estimate raised pulmonary capillary wedge pressure provoked by passive leg lifting in suspected heart failure? Clin Physiol Funct Imaging. 2018 Oct 8. doi: 10.1111/cpf.12547. [Epub ahead of print] PubMed PMID: 30298591.

2: Tossavainen E, Henein MY, Grönlund C, Lindqvist P. Left Atrial Intrinsic Strain Rate Correcting for Pulmonary Wedge Pressure Is Accurate in Estimating Pulmonary Vascular Resistance in Breathless Patients. Echocardiography. 2016 Aug;33(8):1156-65. doi: 10.1111/echo.13226. Epub 2016 May 4. PubMed PMID: 27144613.

3: Henein M, Arvidsson S, Pilebro B, Backman C, Mörner S, Lindqvist P. Long mitral valve leaflets determine left ventricular outflow tract obstruction during exercise in hypertrophic cardiomyopathy. nt J Cardiol. 2016 Jun 1;212:47-53. doi: 10.1016/j.ijcard.2016.03.041. Epub 2016 Mar 16. PubMed PMID: 27031819.

4: Henein MY, Lindqvist P. Assessment of Left Ventricular Diastolic Function by Doppler Echocardiography. Card Fail Rev. 2015 Oct;1(2):87-89. doi: 10.15420/cfr.2015.1.2.87. PubMed PMID: 28785438; PubMed Central PMCID: PMC5490944.

5: Henein MY, Grönlund C, Tossavainen E, Söderberg S, Gonzalez M, Lindqvist P. Right and left heart dysfunction predict mortality in pulmonary hypertension. Clin Physiol Funct Imaging. 2017 Jan;37(1):45-51. doi: 10.1111/cpf.12266. Epub 2015 Jun 19. PubMed PMID: 26096286.

6: Henein MY, Holmgren A, Lindqvist P. Left atrial function in volume versus pressure overloaded left atrium. Int J Cardiovasc Imaging. 2015 Jun;31(5):959-65. doi: 10.1007/s10554-015-0638-6. Epub 2015 Mar 11. PubMed PMID: 25759088.

7: Maras D, Chung R, Duncan A, Li W, Thorp C, Mörner S, Lindqvist P, Henein MY. Patterns of cardiac dysfunction coinciding with exertional breathlessness in hypertrophic cardiomyopathy. Int J Cardiol. 2013 Dec 10;170(2):233-8. doi: 10.1016/j.ijcard.2013.10.059. Epub 2013 Oct 25. PubMed PMID: 24210420.

8: Calcutteea A, Lindqvist P, Soderberg S, Henein MY. Global and regional right ventricular dysfunction in pulmonary hypertension. Echocardiography. 2014 Feb;31(2):164-71. doi: 10.1111/echo.12309. Epub 2013 Aug 10. PubMed PMID: 23930912.

9: Tossavainen E, Söderberg S, Grönlund C, Gonzalez M, Henein MY, Lindqvist P. Pulmonary artery acceleration time in identifying pulmonary hypertension patients with raised pulmonary vascular resistance. Eur Heart J Cardiovasc Imaging. 2013 Sep;14(9):890-7. doi: 10.1093/ehjci/jes309. Epub 2013 Jan 7. PubMed PMID: 23295626.

10: Henein M, Mörner S, Lindmark K, Lindqvist P. Impaired left ventricular systolic function reserve limits cardiac output and exercise capacity in HFpEF patients due to systemic hypertension. Int J Cardiol. 2013 Sep 30;168(2):1088-93. doi: 10.1016/j.ijcard.2012.11.035. Epub 2012 Nov 22. PubMed PMID: 23176776.

11: Zhao Y, Henein MY, Mörner S, Gustavsson S, Holmgren A, Lindqvist P. Residual compromised myocardial contractile reserve after valve replacement for aortic stenosis. Eur Heart J Cardiovasc Imaging. 2012 Apr;13(4):353-60. doi: 10.1093/ejechocard/jer246. Epub 2011 Nov 18. PubMed PMID: 22101151.

12: Lindqvist P, Söderberg S, Gonzalez MC, Tossavainen E, Henein MY. Echocardiography based estimation of pulmonary vascular resistance in patients with pulmonary hypertension: a simultaneous Doppler echocardiography and cardiac catheterization study. Eur J Echocardiogr. 2011 Dec;12(12):961-6. doi: 10.1093/ejechocard/jer222. Epub 2011 Oct 19. PubMed PMID: 22011836.

13: Lindqvist P, Mörner S, Henein MY. Cardiac mechanisms underlying normal exercise tolerance: gender impact. Eur J Appl Physiol. 2012 Feb;112(2):451-9. doi: 10.1007/s00421-011-1992-2. Epub 2011 May 17. PubMed PMID: 21584684.

14: Calcutteea A, Chung R, Lindqvist P, Hodson M, Henein MY. Differential right ventricular regional function and the effect of pulmonary hypertension: three-dimensional echo study. Heart. 2011 Jun;97(12):1004-11. doi: 10.1136/hrt.2010.208900. Epub 2011 Apr 12. PubMed PMID: 21487122.

15: Lindqvist P, Broyd C, Henein MY. E/E': a prime number? Int J Cardiovasc Imaging. 2009 Jan;25(1):41-2. doi: 10.1007/s10554-008-9356-7. Epub 2008 Aug 22. PubMed PMID: 18720027.

16: Lindqvist P, Henein MY, Wikström G. Right ventricular myocardial velocities and timing estimate pulmonary artery systolic pressure. Int J Cardiol. 2009 Oct 2;137(2):130-6. doi: 10.1016/j.ijcard.2008.06.043. Epub 2008 Aug 12. PubMed PMID: 18700177.

17: Lindqvist P, Wikström G, Waldenström A. The use of E/Em and the time interval difference of isovolumic relaxation (TIVRT-IVRTm) in estimating left ventricular filling pressures. Eur J Heart Fail. 2008 May;10(5):490-7. doi: 10.1016/j.ejheart.2008.03.005. Epub 2008 Apr 14. PubMed PMID: 18406665.

18: Lindqvist P, Calcutteea A, Henein M. Echocardiography in the assessment of right heart function. Eur J Echocardiogr. 2008 Mar;9(2):225-34. Review. PubMed PMID: 17588498.

19: Lindqvist P, Waldenström A, Wikström G, Kazzam E. Potential use of isovolumic contraction velocity in assessment of left ventricular contractility in man: A simultaneous pulsed Doppler tissue imaging and cardiac catheterization study. Eur J Echocardiogr. 2007 Aug;8(4):252-8. Epub 2006 Jun 19. PubMed PMID: 16784895.

20: Lindqvist P, Waldenström A, Wikström G, Kazzam E. Right ventricular myocardial isovolumic relaxation time and pulmonary pressure. Clin Physiol Funct Imaging. 2006 Jan;26(1):1-8. PubMed PMID: 16398663.