Invasive hemodynamic testing plays a critical role in the diagnosis and categorization of pulmonary hypertension (PH).1 Although echocardiography serves a complimentary role, its use in the diagnosis of PH is mainly in the analysis of cardiac structure and function (especially examination of the right ventricle), with several studies showing the inaccuracies of Doppler-derived pulmonary artery systolic pressure.2 Recently, invasive hemodynamics have taken center stage in the debate surrounding the presence and classification of PH in heart failure with preserved ejection fraction (HFpEF).3 Given the increasing recognition that treatment of patients with HFpEF may require a more nuanced, phenotype-specific approach, it is therefore not surprising that specific randomized clinical trials are under way for the management of the combined precapillary and postcapillary PH subtype of PH-HFpEF with an endothelin receptor antagonist (SERENADE trial, NCT03153111) and an oral prostacyclin analogue (SOUTHPAW trial, NCT03037580).
Shah SJ. Population-Based Studies of Invasive HemodynamicsA Glimpse Into the Future. JAMA Cardiol. 2018;3(4):306–307. doi:10.1001/jamacardio.2018.0163
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