Exercise right heart catheterization for pulmonary hypertension identified on screening echocardiography in adult survivors of childhood cancer: A report from the St. Jude Lifetime Cohort

Pediatr Blood Cancer. 2018 Jan;65(1):10.1002/pbc.26769. doi: 10.1002/pbc.26769. Epub 2017 Aug 26.

Abstract

Pulmonary hypertension, determined noninvasively by tricuspid regurgitant jet velocity on Doppler echocardiography, was previously identified in 25% of long-term survivors who received chest-directed radiotherapy. To validate noninvasively defined pulmonary hypertension, survivors (mean age 48 years), exposed to chest radiotherapy, underwent right heart catheterization with planned cardiopulmonary exercise testing during catheterization. Eight participants had an elevated mean pulmonary artery pressure at rest (≥25 mm Hg) or with subsequent exercise (>30 mm Hg), evidence of hemodynamically confirmed pulmonary hypertension by right heart catheterization. Cardiopulmonary exercise testing further defined the magnitude and etiology of cardiopulmonary limitations in this life-threatening late effect.

Keywords: cancer; exercise; pediatric; pulmonary hypertension; survivor.

MeSH terms

  • Adult
  • Adult Survivors of Child Adverse Events*
  • Cancer Survivors
  • Cardiac Catheterization*
  • Echocardiography, Doppler*
  • Female
  • Humans
  • Hypertension, Pulmonary / diagnostic imaging*
  • Hypertension, Pulmonary / physiopathology*
  • Hypertension, Pulmonary / therapy*
  • Male
  • Middle Aged