The Straightforward Truth Regarding INSRR

Furthermore, echocardiography is a useful and noninvasive modality not only for estimating pulmonary pressure but also for determining underlying anatomical and functional cardiac abnormalities in patients with suspected PH. However, the diagnosis of PH and the assessment of vasodilatory capacity of pulmonary vasculature require right heart catheterization. Other diagnostic tests may include serologic testing for collagen vascular diseases, pulmonary function tests, chest imaging, ventilation-perfusion scanning, and arterial blood BLZ945 gases for underlying pulmonary diseases. There are no formal guidelines for routine sleep study in patients with PH; however, in view of the high prevalence of nocturnal hypoxemia and OSA in PH, patients with PH should BMS-754807 cost be screened for sleep-disordered breathing by sleep study.19 Effect of treatment of OSA on PH In one of the first studies of the effect of continuous positive airway pressure (CPAP) treatment on pulmonary hemodynamics in OSA, Sforza et al.83 evaluated seven patients with PH with right heart catheterization before and after 1 year of CPAP treatment. Despite some improvement in oxygen saturation, mean Ppa did not change. A decade later, Alchanatis et al.14 examined the effect of CPAP therapy in six patients with OSA and PH diagnosed on echocardiography and confirmed by right heart catheterization with normal PAOP values. After more than 6 months of CPAP therapy, there was a significant reduction in mean Ppa value from 25.6 �� 4.0 mmHg to 19.5 �� 1.6 mmHg (P INSRR to decreased pulmonary vascular resistance and decreased vasoconstrictive response to hypoxic stimulus.84 In a randomized, sham-controlled crossover study involving 10 patients with OSA and PH (right ventricular systolic pressure [RVSP] >30 mmHg estimated by Doppler echocardiograph) and no known cardiac or lung diseases, 12 weeks of CPAP therapy decreased RVSP from 28.8 �� 7.9 mmHg to 24.0 �� 5.8 mmHg (P