Distensibility, an Early Disease Marker of Pulmonary Vascular Health: Ready for Clinical Application

Similar to Thomas Syndenham linking (systemic) arteries with an individual's health in 1600s,(1) pulmonary vascular health has been linked to exercise intolerance and clinical outcomes in recent years.(2,3) These reports include rare diseases such as pulmonary arterial hypertension (PAH) and common diseases such as heart failure with preserved ejection fraction.(3,4) Pulmonary vascular health can be quantified by hemodynamic afterload faced by the right ventricle (RV afterload), which comprises steady and pulsatile components.(5,6) Although the steady load is captured by clinical metrics of pulmonary vascular resistance (PVR), the pulsatile load can be assessed with variable precision by different metrics: the simplified metric of pulmonary arterial compliance computed as stroke volume/pulmonary pulse pressure,(7) bioengineering metrics of pulmonary vascular impedance,(8,9) and pulmonary vascular distensibility with exercise(10,11) (Figure).

Automated summary

In recent years, pulmonary vascular health has been found to be related to exercise intolerance and clinical outcomes. The health of pulmonary blood vessels can be quantified by the hemodynamic load faced by the right ventricle, which includes steady and pulsatile components. Different metrics, such as pulmonary arterial compliance, pulmonary vascular impedance, and pulmonary vascular distensibility with exercise, can assess the pulsatile load.