Aben Rieta, Burton Timothy, Fathieh Farhad, Nemati Navid, Gillins Horace R, Shadforth Ian, Ramchandani Shyam, Bridges Charles R, Cheong Adrian, Sogade Felix
Atrium Health Navicent, Macon, Georgia, USA.
Analytics for Life, Toronto, Canada.
JACC Case Rep. 2025 Sep 3;30(26):104876. doi: 10.1016/j.jaccas.2025.104876.
Pulmonary hypertension (PH) is frequently underdiagnosed due to limitations of transthoracic echocardiography, particularly when tricuspid regurgitant velocity (TRV) is unmeasurable. CorVista PH (point-of-care test for pulmonary hypertension [POC-PH]) is a novel, Food and Drug Administration-cleared point-of-care diagnostic with 82% sensitivity and 92% specificity for identifying mean pulmonary artery pressure elevation.
We present a patient who underwent multiple transthoracic echocardiograms negative for PH. POC-PH testing prompted right heart catheterization, revealing group 2 PH, and enabling the diagnosis of heart failure with preserved ejection fraction. We also present 3 patients with measurable TRV, all of whom tested positive on POC-PH and were confirmed to have PH via right heart catheterization. These included both precapillary and postcapillary PH phenotypes.
An average of 3 transthoracic echocardiograms are required to diagnose pulmonary arterial hypertension spanning a period exceeding 2 years.
TAKE-HOME MESSAGE: POC-PH demonstrated clinical utility in identifying PH where transthoracic echocardiography failed to raise suspicion.
由于经胸超声心动图存在局限性，肺动脉高压（PH）常常未被诊断出来，尤其是当三尖瓣反流速度（TRV）无法测量时。CorVista PH（肺动脉高压即时检验[POC-PH]）是一种新型的、获得美国食品药品监督管理局批准的即时诊断方法，用于识别平均肺动脉压升高时的灵敏度为82%，特异性为92%。
我们报告了一名患者，其多次经胸超声心动图检查结果显示PH为阴性。POC-PH检测促使进行了右心导管检查，结果显示为2型PH，并得以诊断射血分数保留的心力衰竭。我们还报告了3名TRV可测量的患者，他们的POC-PH检测均呈阳性，并通过右心导管检查确诊为PH。这些患者包括毛细血管前和毛细血管后PH两种表型。
诊断肺动脉高压平均需要进行3次经胸超声心动图检查，时间跨度超过2年。
POC-PH在经胸超声心动图未能引起怀疑的情况下识别PH方面显示出临床实用性。
