Valle Felipe H, Mohammed Basma, Wright Stephen P, Bentley Robert, Fam Neil P, Mak Susanna
Division of Cardiology, Mount Sinai Hospital/University Health Network Toronto, Canada.
Division of Cardiology, St Michael's Hospital/University of Toronto Toronto, Canada.
Interv Cardiol. 2021 Feb 15;16:e01. doi: 10.15420/icr.2020.17. eCollection 2020 Apr.
The use of exercise right heart catheterisation for the assessment of cardiovascular diseases has regained attention recently. Understanding physiologic haemodynamic exercise responses is key for the identification of abnormal haemodynamic patterns. Exercise total pulmonary resistance >3 Wood units identifies a deranged haemodynamic response and when total pulmonary resistance exceeds 3 Wood units, an exercise pulmonary artery wedge pressures/cardiac output slope >2 mmHg/l/min indicates the presence of underlying exercise-induced pulmonary hypertension related to left heart disease. In the evolving field of transcatheter interventions for valvular heart disease, exercise right heart catheterisation may objectively unmask symptoms and underlying haemodynamic abnormalities. Further studies are needed on the use of the procedure to inform the selection of patients who might receive the most benefit from transcatheter interventions for valvular heart diseases.
近年来，运动性右心导管检查在心血管疾病评估中的应用重新受到关注。了解生理性血流动力学运动反应是识别异常血流动力学模式的关键。运动时总肺阻力>3伍德单位表明血流动力学反应紊乱，当总肺阻力超过3伍德单位时，运动肺动脉楔压/心输出量斜率>2 mmHg/l/min表明存在与左心疾病相关的潜在运动性肺动脉高压。在不断发展的心脏瓣膜病经导管介入治疗领域，运动性右心导管检查可能会客观地揭示症状和潜在的血流动力学异常。需要进一步研究该检查方法，以指导选择可能从心脏瓣膜病经导管介入治疗中获益最大的患者。
