During right heart catheterization (RHC), the “acute vasodilator test” offers valuable insights into pulmonary circulation by evaluating vasoreactivity. A positive result identifies a rare pulmonary arterial subtype that may benefit from long-term calcium-channel blocker therapy (the so called “responders”).
A recent study re-examines the applications, criteria, and objectives of acute vasodilator testing in pulmonary hypertension patients beyond World Health Organisation Group 1, proposing a novel approach to characterize pulmonary vascular response during diagnostic right heart catheterization.
The authors advocate for a continuous multi-parameter assessment that captures the complete right ventricular afterload profile during testing, incorporating measures such as the pulmonary vascular resistance-pulmonary arterial capacitance relationship and alpha distensibility coefficient. This approach could evaluate the residual vasoreactive capacity of the pulmonary circulation as a provocative test to predict patient outcomes and therapeutic responses.
Citation
Grignola JC, Trujillo P, Sandoval J, Domingo E. Acute pulmonary vasoreactivity: a simple test revisited in the contemporary era – a narrative review. Int J Cardiol Heart Vasc. 2025 Dec 3;62:101847. doi: 10.1016/j.ijcha.2025.101847. PMID: 41438393; PMCID: PMC12719676.
Read more at this link on the International Journal of Cardiology Heart and Vasculature