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Current Approach to the Diagnosis and Management of Portopulmonary Hypertension.
- Source :
-
Current gastroenterology reports [Curr Gastroenterol Rep] 2016 Jun; Vol. 18 (6), pp. 29. - Publication Year :
- 2016
-
Abstract
- Portopulmonary hypertension (POPH) is a form of pulmonary arterial hypertension occurring in the setting of portal hypertension with or without hepatic cirrhosis. The presence of both portal and pulmonary vascular disease contributes to complicated hemodynamics and therapeutic challenges, though the severities do not appear to correlate directly. Diagnosis of POPH, and distinction from the commonly observed hyperdynamic state of end-stage liver disease, is typically accomplished with an initial screening transthoracic echocardiogram, followed by right heart catheterization for confirmation of hemodynamic parameters. Though few studies have directly evaluated use in POPH, pulmonary artery-directed therapy is the cornerstone of management, along with consideration of liver transplantation. Perioperative and long-term outcomes are variable, but uniformly worse in the setting of uncontrolled pulmonary pressures. Risk stratification and optimal patient selection for these interventions are areas of ongoing investigation.
- Subjects :
- Antihypertensive Agents therapeutic use
Endothelin Receptor Antagonists therapeutic use
Guanylate Cyclase physiology
Humans
Hypertension, Portal epidemiology
Hypertension, Portal physiopathology
Hypertension, Portal therapy
Hypertension, Pulmonary epidemiology
Hypertension, Pulmonary physiopathology
Hypertension, Pulmonary therapy
Liver Transplantation
Phosphodiesterase 5 Inhibitors therapeutic use
Prostaglandins therapeutic use
Hypertension, Portal diagnosis
Hypertension, Pulmonary diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1534-312X
- Volume :
- 18
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Current gastroenterology reports
- Publication Type :
- Academic Journal
- Accession number :
- 27098816
- Full Text :
- https://doi.org/10.1007/s11894-016-0504-2