PMID- 35514786
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230916
IS  - 2045-8932 (Print)
IS  - 2045-8940 (Electronic)
IS  - 2045-8932 (Linking)
VI  - 12
IP  - 2
DP  - 2022 Apr
TI  - Pulmonary hypertensive crisis in children with pulmonary arterial hypertension 
      undergoing cardiac catheterization.
PG  - e12067
LID - 10.1002/pul2.12067 [doi]
LID - e12067
AB  - Pediatric patients with pulmonary arterial hypertension (PAH) are considered to 
      be at risk for pulmonary hypertensive crisis (PHC) or even death during right 
      heart catheterization (RHC). This retrospective study was designed to identify 
      the risks and clinical characteristics associated with PHC in pediatric PAH 
      patients. We included 163 consecutive procedures from 147 pediatric patients 
      diagnosed with PAH who underwent diagnostic RHC in Beijing Anzhen Hospital 
      between January 2007 and December 2020. The average patient age was 9.0 +/- 4.7 
      years and 84 (51.5%) were females. Before RHC, over 20% of patients were in New 
      York Heart Association (NYHA) class III-IV. Sedation or general intravenous 
      anesthesia was used in 103 procedures (63.2%), with spontaneous breathing in 
      93.2%. PHC occurred in 19 patients (11.7%), 5 (3.1%) required cardiac 
      compression, and 1 died (0.6%). Compared to patients without PHC, those who 
      experienced PHC were more likely to be in NYHA class III-IV (p = 0.012) before 
      RHC, require sedation (p = 0.011), had echocardiographic indices of higher peak 
      tricuspid regurgitation velocity (p = 0.018), and right ventricle (RV) to left 
      ventricle (LV) ratio (p < 0.001). Multivariate logistic regression for PHC 
      identified the need for sedation and a higher RV/LV ratio as independent 
      predictors. In conclusion, the risk of RHC remains significant in children with 
      PAH, particularly in those with severe RV dilation who require sedation during 
      cardiac catheterization. Comprehensive evaluation, close monitoring, and 
      appropriate treatment before and during the procedure are essential for reducing 
      mortality.
CI  - (c) 2022 The Authors. Pulmonary Circulation published by John Wiley & Sons Ltd on 
      behalf of Pulmonary Vascular Research Institute.
FAU - Li, Qiangqiang
AU  - Li Q
AUID- ORCID: 0000-0002-2649-6775
AD  - Department of Pediatric Cardiology, Beijing Anzhen Hospital Capital Medical 
      University Beijing China.
FAU - Zhang, Chen
AU  - Zhang C
AD  - Department of Pediatric Cardiology, Beijing Anzhen Hospital Capital Medical 
      University Beijing China.
FAU - Wang, Rong
AU  - Wang R
AD  - Center for Anesthesiology, Beijing Anzhen Hospital Capital Medical University 
      Beijing China.
FAU - Keller, Bradley B
AU  - Keller BB
AD  - Greater Louisville and Western Kentucky Practice Cincinnati Children's Heart 
      Institute Louisville Kentucky USA.
FAU - Gu, Hong
AU  - Gu H
AD  - Department of Pediatric Cardiology, Beijing Anzhen Hospital Capital Medical 
      University Beijing China.
LA  - eng
PT  - Journal Article
DEP - 20220418
PL  - United States
TA  - Pulm Circ
JT  - Pulmonary circulation
JID - 101557243
PMC - PMC9063957
OTO - NOTNLM
OT  - cardiac catheterization
OT  - complications
OT  - pediatric
OT  - pulmonary arterial hypertension
EDAT- 2022/05/07 06:00
MHDA- 2022/05/07 06:01
PMCR- 2022/04/18
CRDT- 2022/05/06 05:29
PHST- 2022/01/20 00:00 [received]
PHST- 2022/02/20 00:00 [revised]
PHST- 2022/03/01 00:00 [accepted]
PHST- 2022/05/06 05:29 [entrez]
PHST- 2022/05/07 06:00 [pubmed]
PHST- 2022/05/07 06:01 [medline]
PHST- 2022/04/18 00:00 [pmc-release]
AID - PUL212067 [pii]
AID - 10.1002/pul2.12067 [doi]
PST - epublish
SO  - Pulm Circ. 2022 Apr 18;12(2):e12067. doi: 10.1002/pul2.12067. eCollection 2022 
      Apr.