Health Dictionary
Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Portopulmonary hypertension echocardiography or ultrasound
Introduction
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Overview
Overview
Echocardiography
Echocardiography
The diagnosis of portopulmonary hypertension is based on hemodynamic criteria:
- . Portal hypertension and/or liver disease (clinical diagnosis—ascites/varices/splenomegaly)
- . Mean pulmonary artery pressure—MPAP > 25 mmHg at rest
- . Pulmonary vascular resistance—PVR > 240 dynes s cm−5
- . Pulmonary artery occlusion pressure— PAOP < 15mmHg or transpulmonary gradient—TPG > 12 mmHg where TPG = MPAP − PAOP.[1]
The diagnosis is usually first suggested by a transthoracic echocardiogram, part of the standard pre-transplantation work-up. Echocardiogram estimated pulmonary artery systolic pressures of 40 to 50 mm Hg are used as a screening cutoff for PPH diagnosis,[2] with a sensitivity of 100% and a specificity as high as 96%. The negative predictive value of this method is 100% but the positive predictive value is 60%.[3]
References
References
- ↑ Swanson KL et al. Survival in Portopulmonary Hypertension: Mayo Clinic Experience Categorized by Treatment Subgroups. Am J Transpl 2008; 8: 2445–2453
- ↑ Torregosa et al. Role of Doppler echos in the assessment of PPHTN in liver transplant candidates. Transplantation 2001;71:572-574
- ↑ Colle et al. Diagnosis of portopulmonary hypertension in candidates for liver transplant: a prospective study. Hepatology 2003;37:401-209
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: