Pulmonary Vascular Disease Clinical Trial
Official title:
Ad Hoc Analysis for the Evaluation of Dynamic Pulmonary Vascular Resistance in Patients With a Closed Ventricular Septal Defect
Pulmonary arterial hypertension (PAH) in patients with congenital heart disease usually
develops secondary to chronic volume overload of the pulmonary circulation following left to
right shunt. This overload leads to elevated pulmonary artery pressure (PAP) and later to
increased pulmonary vascular resistance (PVR), leading to right ventricular dysfunction,
considerable morbidity and even mortality.
Since PAH nowadays is mostly detected when symptoms occur and PAP are elevated, the disease
already evolved to an advanced stage and treatment is often initiated too late. Our research
group standardized the technique for the detection of early pulmonary vascular disease by
bicycle stress echocardiography. The investigators now aim to assess this exercise technique
in a group of patients with ventricular septal defect.
Pulmonary arterial hypertension (PAH) in patients with congenital heart disease usually
develops secondary to chronic volume overload of the pulmonary circulation following left to
right shunt. This overload leads to elevated pulmonary artery pressure (PAP) and later to
increased pulmonary vascular resistance (PVR). PAH may lead to right ventricular and right
atrial dysfunction, which may implicate considerable morbidity and even mortality.
Since PAH nowadays is mostly detected when symptoms occur and PAP are elevated, the disease
already evolved to an advanced stage and treatment is often initiated too late. Our research
group standardized the technique for the detection of early pulmonary vascular disease by
bicycle stress echocardiography. Exercise-induced pulmonary hypertension has been recognised
as a clinical entity, but is not included in the current guidelines on pulmonary
hypertension. Further research in this area might imply the need for revision of the current
PAH detection and treatment strategy.
By performing stress echocardiography and cardiopulmonary exercise testing, the
investigators want to reach the following objectives:
- To answer the question whether the abnormal increase in PAP during exercise, seen in
patients with late atrial septal defect (ASD) type secundum closure, is also present in
congenital heart disease (CHD) patients who were treated for other shunt lesions.
- To apply this early detection technique in a broader population of CHD patients and to
better define the predictive value of an elevated PVR during exercise.
;
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