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Vol. 47. Issue S7.
Hipertensión pulmonar
Pages 7-11 (November 2011)
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Vol. 47. Issue S7.
Hipertensión pulmonar
Pages 7-11 (November 2011)
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Papel de la ecocardiografía ante la sospecha de hipertensión pulmonar
Role of echocardiography in suspected pulmonary hypertension
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Francisco Javier Guerra Ramos
Corresponding author
fcojavguerra@hotmail.com

Autor para correspondencia.
Servicio de Neumología, Hospital Universitario Insular, Las Palmas de Gran Canaria, España
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La ecocardiografía es el método no invasivo de elección para el estudio del paciente con sospecha de hipertensión pulmonar. La ecocardiografía permite estimar la presión arterial pulmonar sistólica y, además, puede proporcionar información adicional acerca de la causa y las consecuencias de la enfermedad. Para la estimación de la presión pulmonar sistólica, que es equivalente a la presión sistólica del ventrículo derecho, se utiliza la velocidad máxima del flujo de insuficiencia tricuspídea y la presión en la aurícula derecha que, a su vez, se estima basándose en el grado de dilatación de la vena cava inferior. Otros datos que deben ser evaluados son los relacionados con las dimensiones de las cavidades derechas y la función ventricular derecha. A diferencia del ventrículo izquierdo, el ventrículo derecho posee una anatomía y geometría complejas que dificultan el cálculo de su función sistólica. Por ello, a lo largo de los años, se han ido desarrollando diferentes métodos indirectos para estimar la función sistólica derecha, de las que la excursión sistólica del plano del anillo tricuspídeo (TAPSE) y el índice de Tei son las más utilizadas. Nuevos métodos ecocardiográficos como el estudio de la deformación miocárdica (strain) y la ecocardiografía tridimensional proporcionarán, en un futuro inmediato, información adicional sobre la función cardíaca en los pacientes afectos de hipertensión pulmonar. Por último, la ecocardiografía puede proporcionar datos que sugieran una mala evolución de la enfermedad a corto y medio plazo por lo que es imprescindible su correcta determinación y caracterización.

Palabras clave:
Hipertensión pulmonar
Ecocardiografía
Ventrículo derecho
Función sistólica
Abstract

Echocardiography is the non-invasive method of choice for the study of patients with suspected pulmonary hypertension. This technique allows systolic pulmonary artery pressure to be estimated and can also provide additional information on the cause and effects of the disease. To estimate systolic pulmonary pressure, equivalent to right ventricular systolic pressure, maximal flow velocity of tricuspid regurgitation and right atrial pressure – estimated on the basis of the degree of inferior vena cava dilation – can be employed. Other parameters that should be evaluated are those related to right cavity size and right ventricular function.

Unlike the left ventricle, the anatomy and geometry of the right ventricle is complex, hampering calculation of its systolic function. Consequently, over the years, various indirect methods have been developed to estimate right systolic function, the most commonly used being tricuspid annular plane systolic excursion (TAPSE) and the Tei index. New echocardiographic methods such as study of myocardial deformation (strain) and three-dimensional echocardiography may soon provide data suggesting poor clinical course in the short and medium term. Consequently, accurate determination and characterization of these data are essential.

Keywords:
Pulmonary hypertension
Echocardiography
Right ventricle
Systolic function
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