Facilitating Earlier Diagnosis of Pulmonary Hypertension Using a Novel Noninvasive Diagnostic

Abstract

Background: 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.

Summary: 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.

Discussion: 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.

Keywords: Doppler ultrasound; echocardiography; pulmonary hypertension; right-sided catheterization.