Hypertension artérielle pulmonaire et échocardiographie

Echocardiography is an important tool in the management of patients with pulmonary arterial hypertension (PAH). The new ESC-ERS guidelines specify its role, essentially in the screening proposing criteria for estimating the presence of pulmonary hypertension based on tricuspid regurgitation peak velocity. Nonetheless, echocardiographic examination can be separated into three phases. First, morphologic analysis appreciates the impact of PAH on right and left heart chambers. Second, functionnal assessment of right ventricle can be done by classical parameters or by new techniques such as Tissue Doppler Imaging, 2D speckle imaging and 3D echocardiography. At least hemodynamics analysis allows, theoretically, the estimation of most of the parameters measured during right heart catheterization. However, in spite of all the realized progress, echocardiography still suffers from inadequate reliability in most of parameters measurements in everyday life, and cannot reliably defines strong parameters for follow-up and prognosis because of the lack of prospective confirmatory data.