Abstract
A physiological approach to the analysis of hemodynamic data in pulmonary hypertension (PH) has the advantage of reducing the large number (well over 100) of potential causal illnesses into four simple mechanisms. A fifth condition is composed of mixtures of the four basic mechanisms. This approach was beautifully described by Paul Wood, the great cardiologist whose name is given to the units of pulmonary vascular resistance (PVR), Wood units. This approach uses well understood physiological contributions to pulmonary vascular pressure. It is powerful, the major uncertainty being in determination of the magnitude of each mechanism in patients that have mixed PH of several causes. It also makes sense of the occasionally awkward clustering of conditions in the clinical classification of the World Symposium, which omits pulmonary vasoconstriction, hyperkinetic states, and the highly prevalent condition of "mixed" PH. This method of analysis is described and demonstrated, much as Wood did in his writings. The method is useful in the office, the ICU, and in consultation. A basic message from this approach is that correct assessment requires measurement of each of the three major inputs, pulmonary arterial pressure (Ppa), pulmonary a...Continue Reading
References
Jul 9, 1992·The New England Journal of Medicine·S RichP S Levy
Aug 1, 1987·Annals of Internal Medicine·S RichS K Koerner
Jan 1, 1971·Chest·R M HarveyM I Ferrer
Sep 4, 1998·The European Respiratory Journal·O SitbonG Simonneau
Sep 16, 2000·Chest·M J KrowkaR H Wiesner
Jul 14, 2001·The New England Journal of Medicine·P H Hackett, R C Roach
Sep 20, 1958·British Medical Journal·P WOOD
Oct 1, 1958·British Heart Journal·P WOOD
Sep 2, 1965·The New England Journal of Medicine·E BRAUNWALDA G MORROW
Oct 16, 2004·Chest·Denis ChemlaPhilippe Hervé
Feb 4, 2006·American Journal of Respiratory and Critical Care Medicine·Marc HumbertGérald Simonneau
Mar 7, 2007·Circulation·Dante Penaloza, Javier Arias-Stella
Aug 7, 2008·Chest·Robert B Schoene
Feb 3, 2009·Vascular Health and Risk Management·Mykola V TsapenkoOgnjen Gajic
Mar 28, 2009·The European Respiratory Journal·G KovacsH Olschewski
May 3, 2011·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Raymond L BenzaIrene M Lang
Feb 3, 2012·Physiological Reviews·J T SylvesterJeremy P T Ward
Jan 26, 2013·American Journal of Respiratory and Critical Care Medicine·Robert NaeijeGregory D Lewis
Dec 4, 2013·Circulation. Heart Failure·Ivan M RobbinsJohn H Newman
Dec 21, 2013·Journal of the American College of Cardiology·Marius M HoeperDavid B Badesch
Jul 30, 2016·Journal of the American College of Cardiology·Yogesh N V ReddyBarry A Borlaug
Dec 10, 2016·Journal of the American College of Cardiology·Tufik R AssadEvan L Brittain
Mar 31, 2017·European Respiratory Review : an Official Journal of the European Respiratory Society·Gérald SimonneauNick Kim
Dec 14, 2018·The European Respiratory Journal·Gérald SimonneauRogerio Souza
Dec 14, 2018·The European Respiratory Journal·Marc HumbertMarlene Rabinovitch
Dec 14, 2018·The European Respiratory Journal·Steven D NathanWerner Seeger
Feb 25, 2020·Circulation. Heart Failure·W H Wilson TangFranz P Rischard