People with pulmonary hypertension have high blood pressure in the lung arteries rather than in regular circulation. The disease can be caused by several other conditions and diseases, including connective tissue disease, congenital abnormalities of the heart, emphysema, and fibrosis in the lungs. Regardless of what leads to its development, pulmonary hypertension is a serious disease that is difficult to treat. Many patients require a heart-lung transplant, medications to control the high blood pressure in the lungs, and some die from their disease. The median life expectancy for those with PH who remain untreated is 2.8 years.
A recent study explored a novel method of identifying problems in the right ventricle, which in PH must work harder to push blood through the pulmonary arteries when they are affected by high blood pressure. This new technique, called the “global right ventricular longitudinal strain” or GLSRV evaluation is an improved way to measure how much the right ventricle has to work against the pulmonary arteries compared to a regular echocardiogram of the right ventricle. The technique could help target treatment options for PH patients and improve quality of life with the disease.
The study looked at 51 people with pulmonary hypertension and evaluated them using several different right ventricular parameters, including the global right ventricular longitudinal strain pattern. They then followed these patients to see how they progressed during the months following the test. The researchers discovered that those who had a worse GLSRV had a higher incidence of hospitalizations, heart-lung transplants and death.
The hope is that this new method of determining the GLSRV can be used to study the right ventricle more carefully in order to identify those patients who will do well and those patients who will have poor outcomes. If a person with a poor GLSRV can be detected early enough, it is possible that different medications can be prescribed that can dilate the pulmonary arteries, leading to decreased hypertension and a better quality of life. In addition, new drug therapies can be tested as well using the GLSRV as an endpoint to see if the patients will be better managed with new therapies when compared to current therapies.
The GLSRV evaluation isn’t any more difficult to conduct than a regular echocardiogram, but it can tell a lot more about how the right ventricle is functioning. If the patient is identified as having a poor GLSRV evaluation on echocardiogram, they can be monitored more closely with and given different medications in order to avoid adverse outcomes. These patients may be able to be treated with medications alone so that their chances of being hospitalized or suffering death due to pulmonary hypertension can be mitigated.
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