Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital and Imperial College London, London, United Kingdom.
Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, United Kingdom.
J Am Coll Cardiol. 2018 Dec 4;72(22):2778-2788. doi: 10.1016/j.jacc.2018.08.2201.
Echocardiography is the mainstay in screening for pulmonary hypertension (PH). International guidelines suggest echocardiographic parameters for suspecting PH, but these may not apply to many adults with congenital heart disease (ACHD). PH is relatively common in ACHD patients and can significantly affect their exercise capacity, quality of life, and prognosis. Identification of patients who have developed PH and who may benefit from further investigations (including cardiac catheterization) and treatment is thus extremely important. A systematic review and survey of experts from the United Kingdom and Ireland were performed to assess current knowledge and practice on echocardiographic screening for PH in ACHD. This paper presents the findings of the review and expert statements on the optimal approaches when using echocardiography to assess ACHD patients for PH, with particular focus on major subgroups: patients with right ventricular outflow tract obstruction, patients with systemic right ventricles, patients with unrepaired univentricular circulation, and patients with tetralogy of Fallot with pulmonary atresia.
超声心动图是筛查肺动脉高压(PH)的主要方法。国际指南建议使用超声心动图参数来怀疑 PH,但这些参数可能不适用于许多患有先天性心脏病(ACHD)的成年人。PH 在 ACHD 患者中较为常见,可显著影响其运动能力、生活质量和预后。因此,识别已经发生 PH 并可能受益于进一步检查(包括心导管检查)和治疗的患者非常重要。对来自英国和爱尔兰的专家进行了系统评价和调查,以评估目前在 ACHD 患者中进行 PH 超声心动图筛查的知识和实践情况。本文介绍了该综述的研究结果以及专家关于使用超声心动图评估 ACHD 患者 PH 的最佳方法的声明,特别关注以下主要亚组:右心室流出道梗阻患者、双心室系统患者、未修复的单心室循环患者和法洛四联症伴肺动脉闭锁患者。