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pulmonary hypertension

J B Hinrichs, T Werncke, T Kaireit, M M Hoeper, K M Olsson, J C Kamp, F K Wacker, F Bengel, C von Falck, I Schatka, B C Meyer
Purpose: To determine if C-Arm computed tomography (CACT) has added diagnostic value in patients suffering from chronic thromboembolic pulmonary hypertension (CTEPH) with a positive mismatch pattern in ventilation/perfusion single photon emission computed tomography (V/Q SPECT). Materials and Methods: 28 patients (23 men, 5 women, 62 ± 18 years) with CTEPH who had undergone SPECT, followed by CACT and right heart catheterization (RHC) were included. Two independent readers reviewed SPECT and CACT. Findings indicating CTEPH and their location (segmental or sub-segmental) were identified (V/Q mismatch in SPECT and vascular pathologies in CACT)...
October 26, 2016: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
Ekkehard Grünig, Nicola Benjamin, Tobias J Lange, Ulrich Krueger, Hans Klose, Claus Neurohr, Heinrike Wilkens, Michael Halank, Hans-Jürgen Seyfarth, Matthias Held, Andrew Traube, Michelle Pernow, E Robert Grover, Benjamin Egenlauf, Felix Gerhardt, Thomas Viethen, Stephan Rosenkranz
BACKGROUND: Subcutaneous treprostinil has dose-dependent beneficial effects in patients with severe pulmonary arterial hypertension, but adverse effects like infusion site pain can lead to treatment discontinuation. OBJECTIVES: The objective of this study was to evaluate safety, tolerability and clinical effects of a rapid up-titration dosing regimen of subcutaneous treprostinil using proactive infusion site pain management. METHODS: Effects of rapid up-titration dosing regimen on tolerability and clinical parameters were evaluated in this 16-week, open-label multi-centre study...
October 27, 2016: Respiration; International Review of Thoracic Diseases
Pendar Farahani
Evidence from literature illustrates that from a pathophysiological perspective, sulfonylureas (SU) may impact the heart three ways: directly by intrinsic properties from a pharmacological receptor perspective, indirectly by adverse effects related to hypoglycemia, and obesity. From a pharmacologlogical receptor perspective, SU can bind to ATP-sensitive potassium channels in cardiomyocytes. Channel binding by SU in cardiac tissue may prevent ischemia myocardial protective mechanisms. From a pathophysiological perspective, obesity is associated with cardiac issues such as pulmonary hypertension, left ventricular hypertrophy, arrhythmia, and atrial fibrillation...
September 13, 2016: Journal of Population Therapeutics and Clinical Pharmacology
Masateru Kawakubo, Hiroshi Akamine, Yuzo Yamasaki, Atsushi Takemura, Kohtaro Abe, Kazuya Hosokawa, Junji Morishita, Michinobu Nagao
In this study, three-dimensional phase contrast magnetic resonance imaging (3D-PC MRI), a novel technique, was validated to assess pulmonary artery (PA) flow in patients with chronic thromboembolic pulmonary hypertension (CTEPH). The MR data of PAs from 3D-PC and two-dimensional PC (2D-PC) from before and after treatment for 3 patients with CTEPH were retrospectively analyzed. Additionally, 3D- and 2D-PC MR scans of PA were performed in 5 healthy volunteers. Correlation of stroke volumes (SVs) obtained by 3D-PC and 2D-PC was analyzed using Pearson's correlation coefficients...
October 25, 2016: Radiological Physics and Technology
Shinichiro Abe, Keiichi Ishida, Masahisa Masuda, Hideki Ueda, Hiroki Kohno, Kaoru Matsuura, Yusaku Tamura, Michiko Watanabe, Goro Matsumiya
OBJECTIVES: Pulmonary endarterectomy (PEA) is an effective treatment for chronic thromboembolic pulmonary hypertension (CTEPH), but postoperative residual hypertension leads to in-hospital mortality. Inhaled epoprostenol sodium (PGI2) and NO are administered for pulmonary hypertension after cardiothoracic surgery. This prospective study provides the first comparative evaluation of the effects of inhaled PGI2 and NO on pulmonary hemodynamics, systemic hemodynamics, and gas exchange in patients developing residual pulmonary hypertension after PEA...
October 25, 2016: General Thoracic and Cardiovascular Surgery
Hiroyuki Sano, Hidekazu Tanaka, Yoshiki Motoji, Yuko Fukuda, Yasuhide Mochizuki, Yutaka Hatani, Hiroki Matsuzoe, Keiko Hatazawa, Hiroyuki Shimoura, Junichi Ooka, Keiko Ryo-Koriyama, Kazuhiko Nakayama, Kensuke Matsumoto, Noriaki Emoto, Ken-Ichi Hirata
Mid-term right ventricular (RV) reverse remodeling after treatment in patients with pulmonary hypertension (PH) is associated with long-term outcome as well as baseline RV remodeling. However, baseline factors influencing mid-term RV reverse remodeling after treatment and its prognostic capability remain unclear. We studied 54 PH patients. Mid-term RV remodeling was assessed in terms of the RV area, which was traced planimetrically at the end-systole (RVESA). RV reverse remodeling was defined as a relative decrease in the RVESA of at least 15% at 10...
October 25, 2016: International Journal of Cardiovascular Imaging
Julio Jiménez, Jute Richter, Taro Nagatomo, Thomas Salaets, Rozenn Quarck, Allard Wagennar, Hongmei Wang, Jeroen Vanoirbeek, Jan Deprest, Jaan Toelen
Bronchopulmonary dysplasia (BPD) is caused by preterm neonatal lung injury and results in oxygen dependency and pulmonary hypertension. Current clinical management fails to reduce the incidence of BPD, which calls for novel therapies. Fetal rabbits have a lung development that mimics humans and can be used as a translational model to test novel treatment options. In preterm rabbits, exposure to hyperoxia leads to parenchymal changes, yet vascular damage has not been studied in this model. In this study we document the early functional and structural changes of the lung vasculature in preterm rabbits that are induced by hyperoxia after birth...
October 24, 2016: International Journal of Molecular Sciences
Milena Masullo, Cosimo Pizza, Sonia Piacente
Oleanolic acid has been considered a good start molecule for synthetic exploitation. Thus hundreds of oleanane triterpenoids have been synthesized and patented. Also many oleanane saponins have been patented for their biological activities and possible pharmaceutical use. Areas covered: Patents reporting the biological activities of oleanane derivatives and saponins with oleanane-type aglycones were examined. Among the synthesized oleanane derivatives, the most promising seem to be 2-cyano-3,12-dioxoolean-1,9(11)-dien-28-oic acid derivatives which interfere with many pathways involved in inflammation, oxidative stress and cell proliferation...
October 26, 2016: Expert Opinion on Therapeutic Patents
Jason Turner, Michael C Turner, Edmund K Kerut
A young female developed progressive dyspnea on minimal exertion. Echocardiography demonstrated a large right heart with severe pulmonary hypertension. Cardiac computed tomographic angiography then demonstrated a superior sinus venosus atrial septal defect with an anomalous right upper pulmonary venous drainage. Echo and CCTA were complementary in making a proper diagnosis.
October 2016: Echocardiography
Dae Woo Park, Andrea Sebastiani, Choon Hwai Yap, Marc A Simon, Kang Kim
Mechanical and structural changes of right ventricular (RV) in response to pulmonary hypertension (PH) are inadequately understood. While current standard biaxial testing provides information on the mechanical behavior of RV tissues using surface markers, it is unable to fully assess structural and mechanical properties across the full tissue thickness. In this study, the mechanical and structural properties of normotensive and pulmonary hypertension right ventricular (PHRV) myocardium through its full thickness were examined using mechanical testing combined with 3D ultrasound speckle tracking (3D-UST)...
2016: PloS One
Amanda N Fletcher, Agostino Molteni, Rakesh Ponnapureddy, Chirag Patel, Mark Pluym, Alan M Poisner
BACKGROUND: Fat embolism (FE) and the consequent fat embolism syndrome (FES) occurring after trauma or surgery can lead to serious pulmonary injury, including ARDS and death. Current treatment of FES is limited to supportive therapy. We have shown in a rat model that the renin angiotensin system (RAS) plays a significant role in the pathophysiology of FE since drugs interfering with the RAS, captopril and losartan, reduce the histopathologic pulmonary damage. The purpose of the current study was to determine if inhibition of renin by aliskiren, an FDA-approved drug for treating hypertension, would produce effective protection in the same model...
October 25, 2016: Journal of Trauma and Acute Care Surgery
Silin Sa, Mingxia Gu, James Chappell, Ning-Yi Shao, Mohamed Ameen, Kathryn A T Elliott, Dan Li, Fabian Grubert, Caiyun G Li, Shalina Taylor, Aiqin Cao, Yu Ma, Ryan Fong, Long Nguyen, Joseph C Wu, Michael P Snyder, Marlene Rabinovitch
RATIONALE: Idiopathic or heritable pulmonary arterial hypertension is characterized by loss and obliteration of lung vasculature. Endothelial cell dysfunction is pivotal to the pathophysiology but different causal mechanisms may reflect a need for patient-tailored therapies. OBJECTIVES: Endothelial cells differentiated from induced pluripotent stem cells were compared to pulmonary arterial endothelial cells from the same patients with idiopathic or heritable pulmonary arterial hypertension, to determine whether they shared functional abnormalities and altered gene expression patterns, that differed from those in unused donor cells...
October 25, 2016: American Journal of Respiratory and Critical Care Medicine
Deniz Koksal, Aydin Seref Koksal, Ahmet Gurakar
Primary biliary cirrhosis (PBC) is a chronic progressive cholestatic liver disease caused by diffuse inflammation, destruction and fibrosis of the intrahepatic bile ducts, ultimately leading to cirrhosis, portal hypertension and liver failure. The pathogenesis of PBC is incompletely understood, but current data suggest roles for genetic susceptibility and environmental factors. PBC is often thought of as an organ-specific autoimmune disease, which mainly targets the liver; however, lung tissue is also a site for autoimmune involvement of PBC...
September 28, 2016: Journal of Clinical and Translational Hepatology
Rubén Kevin Arnold Tapia-Orihuela, Jorge Huaringa-Marcelo, David Loja-Oropeza
Introduction: Situs inversus totalis is an uncommon anomaly which exist a complete transposition of organs and it's occasionally associated with congenital heart diseases, such as tetralogy of fallot. Pheochromocytoma is a rare neuroendocrine tumor with an annual incidence of 2-8 cases per million people and for years has been studied its relationship with the hypoxic pathway. Case Report: A 29 year old male with a history of tetralogy of fallot corrected at 10 years and situs inversus totalis. He was admitted to hospital with a progressive story of four months of constipation, palpitations, headache, dyspnea and sweating...
2016: Journal of Cardiovascular and Thoracic Research
Deepa Prasad, James P Strainic, Khyati Pandya, Peter C Kouretas, Ravi C Ashwath
We report a rare causal association between obstructed supracardiac totally anomalous pulmonary venous drainage and coronary sinus ostial atresia. Our 12-week-old patient developed venous myocardial infarction secondary to coronary venous hypertension because her sole route of coronary venous drainage was obstructed. She recovered after the obstruction was relieved by balloon dilation. Surgical repair then included anastomosis of the pulmonary venous confluence to the left atrium, ligation of the vertical vein, and unroofing of the coronary sinus...
October 2016: Texas Heart Institute Journal
Satoshi Akagi, Kazufumi Nakamura, Teiji Akagi, Koji Nakagawa, Yoichi Takaya, Toshihiro Sarashina, Kentaro Ejiri, Hiroshi Ito
A treatment strategy for patients with pulmonary hypertension (PH) and atrial septal defect (ASD) remains unclear. This study was designed to evaluate the effects of initial repair of ASD followed by treatment with PH-specific drugs in patients with PH and ASD. Eligible patients receive transcatheter ASD closure followed by treatment with bosentan and sildenafil. Right heart catheterization is performed at baseline and at 12, 24 and 48 weeks. The primary endpoint is change in pulmonary artery pressure and pulmonary vascular resistance from baseline to follow-up...
October 2016: Acta Medica Okayama
Hidehiko Maruyama, Yusei Nakata, Akane Kanazawa, Kiyoshi Kikkawa
We sought to clarify the survival and neurodevelopmental outcomes of very low birth weight infants (VLBWIs) and to identify risk factors for death or neurodevelopmental impairment (NDI) in VLBWIs at our hospital. The total study population was 217 infants born in 2005-2012 weighing 1,500 g. We compared their outcomes with those from previous reports analyzed the causes of death. Risk factors for death after discharge or NDI were evaluated by a multivariate logistic regression analysis. The incidences of death or NDI reported revealed in this study and the database of Neonatal Research Network of Japan were 25...
October 2016: Acta Medica Okayama
Ming Zhang, Ya-Li Li, Xia Yang, Hu Shan, Qiu-Hong Zhang, Xiang-Li Feng, Ying-Ying Xie, Jing-Jing Tang, Jie Zhang
OBJECTIVE: To study the serum level of carbohydrate antigen 125 (CA125) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and its relation with pulmonary hypertension. METHODS: Forty-six patients with AECOPD complicated by pulmonary hypertension, 46 with AECOPD and 38 healthy control subjects were examined for their clinical data, pulmonary function, echocardiographic findings, and serum levels of lung tumor markers and brain natriuretic peptide (BNP)...
October 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Nadera Methia, Samia Latreche, Omar Ait Mokhtar, Jean-Jacques Monsuez, Salim Benkhedda
BACKGROUND: Prognosis of systemic sclerosis (SSc) is affected by pulmonary artery hypertension (PAH). METHODS: Among 202 patients (mean age: 46.1 ± 13.3 years; 177 women) with SSc, those with a tricuspid regurgitation (TR) jet maximal velocity at 2D-echocardiography (2DE) < 2.8m/second were not considered at high risk for PAH, whereas those with a TR velocity >3m/second or between 2.8 and 3m/second and associated with dyspnea were. RESULTS: Among 22 patients at risk, 15 (mean age: 50...
October 2016: American Journal of the Medical Sciences
Bedros Taslakian, Larry A Latson, Mylene T Truong, Eric Aaltonen, Maria C Shiau, Francis Girvin, Jeffrey B Alpert, Maj Wickstrom, Jane P Ko
Computed tomography pulmonary angiography (CTPA) has become the primary imaging modality for evaluating the pulmonary arteries. Although pulmonary embolism is the primary indication for CTPA, various pulmonary vascular abnormalities can be detected in adults. Knowledge of these disease entities and understanding technical pitfalls that can occur when performing CTPA are essential to enable accurate diagnosis and allow timely management. This review will cover a spectrum of acquired abnormalities including pulmonary embolism due to thrombus and foreign bodies, primary and metastatic tumor involving the pulmonary arteries, pulmonary hypertension, as well as pulmonary artery aneurysms and stenoses...
November 2016: European Journal of Radiology
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