Page 10 - Assessing right ventricular function and the pulmonary circulation in pulmonary hypertension Onno Anthonius Spruijt

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Pulmonary hypertension:
After successfully and safely using the cardiac catheter technique in animals, Dr. Werner Forssmann performed in 1929 the first recorded human cardiac catheterization of his own right heart. Andre Cournand and Dickinson Richards did further development of this technique for clinical purposes in 1944 and demonstrated the safety and feasibility of this technique in a large cohort of patients. For their contributions to the understanding of cardiac physiology, Forssmann, Cournand and Richards received the Nobel Prize in Physiology in 1956 (Figure 1) [1].
Figure 1: Forssmann, Richards and Cournand receiving the Nobel Prize in Physiology.
Today, the right heart catheterization (RHC) is still the gold standard for the hemodynamic evaluation of the right ventricle (RV) and pulmonary circulation. During a RHC, the pressure is measured and recorded in the right atrium (RA), right ventricle (RV) and pulmonary artery (PA).
Shortly after the clinical introduction of the RHC technique, it became clear that elevated pulmonary vascular pressures were related to symptoms of dyspnea and fatigue. Paul Wood defined in 1958 a mean pulmonary artery pressure (mPAP) of 25 mmHg as the upper limit of normal on the basis of measurements performed in 60 healthy subjects [2]. The same definition of pulmonary hypertension (PH) is still used today and the RHC remains the gold standard for the diagnosis of PH [3].