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https://www.readbyqxmd.com/read/29713818/right-ventriculo-arterial-uncoupling-and-impaired-contractile-reserve-in-obese-patients-with-unexplained-exercise-intolerance
#1
Colm McCabe, Rudolf K F Oliveira, Farbod Rahaghi, Mariana Faria-Urbina, Luke Howard, Richard G Axell, Andrew N Priest, Aaron B Waxman, David M Systrom
BACKGROUND: Right ventricular (RV) dysfunction and heart failure with preserved ejection fraction may contribute to exercise intolerance in obesity. To further define RV exercise responses, we investigated RV-arterial coupling in obesity with and without development of exercise pulmonary venous hypertension (ePVH). METHODS: RV-arterial coupling defined as RV end-systolic elastance/pulmonary artery elastance (Ees/Ea) was calculated from invasive cardiopulmonary exercise test data in 6 controls, 8 obese patients without ePVH (Obese-ePVH) and 8 obese patients with ePVH (Obese+ePVH) within a larger series...
April 30, 2018: European Journal of Applied Physiology
https://www.readbyqxmd.com/read/29603461/metaboreceptor-activation-in-heart-failure-with-reduced-ejection-fraction-linking-cardiac-and-peripheral-vascular-hemodynamics
#2
Zachary Barrett-O'Keefe, Joshua F Lee, Amanda Berbert, Melissa A H Witman, Jose Nativi-Nicolau, Josef Stehlik, Russell S Richardson, D Walter Wray
This study sought to evaluate the muscle metaboreflex in heart failure patients with reduced ejection fraction (HFrEF), with an emphasis on the interaction between cardiac and peripheral vascular hemodynamics across multiple levels of metaboreceptor activation. In 23 HFrEF patients (63 ± 2 yrs) and 15 healthy controls (64 ± 3 yrs), we examined changes in mean arterial pressure (MAP), cardiac output (CO), systemic vascular conductance (SVC), effective arterial elastance (Ea), stroke work (SW), and forearm deoxyhemoglobin concentration during metaboreceptor activation elicited by post-exercise circulatory occlusion (PECO) following three levels of static-intermittent handgrip exercise (15, 30, and 45% maximal voluntary contraction (MVC))...
March 30, 2018: Experimental Physiology
https://www.readbyqxmd.com/read/29573927/stressing-the-cardiopulmonary-vascular-system-the-role-of-echocardiography
#3
REVIEW
Lawrence G Rudski, Luna Gargani, William F Armstrong, Patrizio Lancellotti, Steven J Lester, Ekkehard Grünig, Michele D'Alto, Meriam Åström Aneq, Francesco Ferrara, Rajeev Saggar, Rajan Saggar, Robert Naeije, Eugenio Picano, Nelson B Schiller, Eduardo Bossone
The cardiopulmonary vascular system represents a key determinant of prognosis in several cardiorespiratory diseases. Although right heart catheterization is considered the gold standard for assessing pulmonary hemodynamics, a comprehensive noninvasive evaluation including left and right ventricular reserve and function and cardiopulmonary interactions remains highly attractive. Stress echocardiography is crucial in the evaluation of many cardiac conditions, typically coronary artery disease but also heart failure and valvular heart disease...
March 21, 2018: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/29569422/left-ventricular-remodelling-and-vascular-adaptive-changes-in-adolescents-with-obesity
#4
A Kulkarni, T Gulesserian, J M M D Lorenzo, Y Haroonian, M Ngyuyen, Y Lo, D Wang, D Hsu, F Kaskel, J Mahgerefteh
BACKGROUND: The aim of this study was to determine the effects of obesity on myocardial mechanics and ventriculo-arterial coupling (V-A) in children. METHODS: Strain parameters, stroke volume, arterial elastance, left ventricular (LV) elastance and V-A were compared after adjusting for age and hypertension and after multivariate sub-group analysis between patients with and without obesity. RESULTS: Among 123 retrospectively enrolled subjects, 6-21 years age, 79...
March 22, 2018: Pediatric Obesity
https://www.readbyqxmd.com/read/29502109/cardiopulmonary-exercise-testing-in-patients-following-massive-and-submassive-pulmonary-embolism
#5
Mazen S Albaghdadi, David M Dudzinski, Nicholas Giordano, Christopher Kabrhel, Brian Ghoshhajra, Michael R Jaff, Ido Weinberg, Aaron Baggish
BACKGROUND: Little data exist regarding the functional capacity of patients following acute pulmonary embolism. We sought to characterize the natural history of symptom burden, right ventricular (RV) structure and function, and exercise capacity among survivors of massive and submassive pulmonary embolism. METHODS AND RESULTS: Survivors of submassive or massive pulmonary embolism (n=20, age 57±13.3 years, 8/20 female) underwent clinical evaluation, transthoracic echocardiography, and cardiopulmonary exercise testing at 1 and 6 months following hospital discharge...
March 3, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29386335/effects-of-continuous-positive-airway-pressure-therapy-on-left-ventricular-diastolic-function-a-randomised-sham-controlled-clinical-trial
#6
Chi Young Shim, Darae Kim, Sungha Park, Chan Joo Lee, Hyung-Ju Cho, Jong-Won Ha, Yang-Je Cho, Geu-Ru Hong
Continuous positive airway pressure (CPAP) therapy may decrease left ventricular (LV) loads and improve myocardial oxygenation. In this study, we investigated the effect of CPAP on LV diastolic function compared with sham treatment in patients with severe obstructive sleep apnoea (OSA).This 3-month prospective single-centre randomised sham-controlled trial analysed 52 patients with severe OSA. Patients were randomly assigned (1:1) to receive either CPAP or sham treatment for 3 months. The main investigator and patients were masked to the trial randomisation...
February 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29369739/organ-level-right-ventricular-dysfunction-with-preserved-frank-starling-mechanism-in-a-mouse-model-of-pulmonary-arterial-hypertension
#7
Zhijie Wang, Jitandrakumar R Patel, David A Schreier, Timothy A Hacker, Richard L Moss, Naomi C Chesler
Pulmonary arterial hypertension (PAH) is a rapidly fatal disease in which mortality is due to right ventricular (RV) failure. It is unclear whether RV dysfunction initiates at the organ-level or the subcellular-level or both. We hypothesized that chronic pressure overload-induced RV dysfunction begins at the organ level with preserved Frank-Starling mechanism in myocytes. To test this hypothesis, we induced PAH with SUGEN+hypoxia (HySu) in mice and measured RV whole-organ and subcellular functional changes by in vivo pressure-volume measurements and in vitro trabeculae length-tension measurements, respectively at multiple time points for up to 56 days...
January 25, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29325918/bioactive-fraction-of-rhodiola-algida-against-chronic-hypoxia-induced-pulmonary-arterial-hypertension-and-its-anti-proliferation-mechanism-in-rats
#8
Xingmei Nan, Shanshan Su, Ke Ma, Xiaodong Ma, Ximeng Wang, Dongzhu Zhaxi, Rili Ge, Zhanqiang Li, Dianxiang Lu
ETHNOPHARMACOLOGICAL RELEVANCE: Rhodiola algida var. tangutica (Maxim.) S.H. Fu is a perennial plant of the Crassulaceae family that grows in the mountainous regions of Asia. The rhizome and roots of this plant have been long used as Tibetan folk medicine for preventing high latitude sickness. AIM OF THE STUDY: The aim of this study was to determine the effect of bioactive fraction from R. algida (ACRT) on chronic hypoxia-induced pulmonary arterial hypertension (HPAH) and to understand the possible mechanism of its pharmacodynamic actions...
April 24, 2018: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/29316567/modern-invasive-hemodynamic-assessment-of-pulmonary-hypertension
#9
Alberto Pagnamenta, Frédéric Lador, Andrea Azzola, Maurice Beghetti
Since 1998 pulmonary hypertension has been clinically classified into five well-defined, distinct categories. A definitive diagnosis of pulmonary hypertension requires the invasive confirmation of an elevated mean pulmonary artery pressure of 25 mm Hg or above during a right heart catheterization. From a hemodynamic point of view, pulmonary hypertension is classified into precapillary and postcapillary pulmonary hypertension on the basis of a pulmonary artery wedge pressure threshold value of 15 mm Hg. Pulmonary vascular resistance is better characterized by multi-point pressure/flow measurements than by single-point determination...
2018: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/29249904/the-inodilator-levosimendan-as-a-treatment-for-acute-heart-failure-in-various-settings
#10
Finn Gustafsson, Fabio Guarracino, Robert H G Schwinger
Levosimendan is an inodilator developed for treatment of acute heart failure. It was shown to enhance cardiac contractility, and to exert a vasodilatory effect in all vascular beds. In some trials, the use of levosimendan was associated with cardioprotective effects. These distinctive qualities may be relevant to its use in a range of acute heart failure settings and/or complications, including acute coronary syndromes and cardiogenic shock. It is conjectured that part of the benefit of levosimendan may arise from restoration of ventriculo-arterial coupling via optimization of the ratio of arterial to ventricular elastance and the transfer of mechanical energy...
March 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://www.readbyqxmd.com/read/29202543/-experts-consensus-on-the-management-of-the-right-heart-function-in-critically-ill-patients
#11
X T Wang, D W Liu, H M Zhang, Y Long, X D Guan, H B Qiu, K J Yu, J Yan, H Zhao, Y Q Tang, X Ding, X C Ma, W Du, Y Kang, B Tang, Y H Ai, H W He, D C Chen, H Chen, W Z Chai, X Zhou, N Cui, H Wang, X Rui, Z J Hu, J G Li, Y Xu, Y Yang, B Ouyan, H Y Lin, Y M Li, X Y Wan, R L Yang, Y Z Qin, Y G Chao, Z Y Xie, R H Sun, Z Y He, D F Wang, Q Q Huang, D P Jiang, X Y Cao, R G Yu, X Wang, X K Chen, J F Wu, L N Zhang, M G Yin, L X Liu, S W Li, Z J Chen, Z Luo
To establish the experts consensus on the right heart function management in critically ill patients. The panel of consensus was composed of 30 experts in critical care medicine who are all members of Critical Hemodynamic Therapy Collaboration Group (CHTC Group). Each statement was assessed based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) principle. Then the Delphi method was adopted by 52 experts to reassess all the statements. (1) Right heart function is prone to be affected in critically illness, which will result in a auto-exaggerated vicious cycle...
December 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29171957/carotid-artery-longitudinal-wall-motion-regulatory-factors-and-implications-for-arterial-health
#12
Jason S Au
The carotid artery wall moves longitudinally along the length of the vessel, although little is known about what causes this motion, or what health information it represents. The overarching purpose of this dissertation was to investigate the regulation of carotid artery longitudinal wall motion (CALM) in humans, as well as how CALM can be used to infer information about arterial health. Through observational and experimental designs, we tested evidence for a structural ventricular-vascular coupling effect, which postulates that systolic anterograde CALM is influenced by the forward blood shear rate while systolic retrograde CALM is influenced by left ventricular rotation, although the data suggest a moderate influence of left ventricular rotation, and minimal influence of shear rate...
January 2018: Applied Physiology, Nutrition, and Metabolism, Physiologie Appliquée, Nutrition et Métabolisme
https://www.readbyqxmd.com/read/29143384/enhanced-ventricular-arterial-coupling-during-a-2-year-physical-activity-programme-in-patients-with-rheumatoid-arthritis-a-prospective-substudy-of-the-physical-activity-in-rheumatoid-arthritis-2010-trial
#13
P Sarajlic, C Fridén, L H Lund, A Manouras, A Venkateshvaran, S C Larsson, B Nordgren, C H Opava, I E Lundberg, M Bäck
OBJECTIVE: To establish how guided physical activity in patients with rheumatoid arthritis (RA) without known cardiovascular disease affected vascular and cardiac function, and how these two entities were prospectively interconnected in this patient group. METHODS: Prospective substudy of 29 participants in the Physical Activity in RA (PARA) 2010 trial. All subjects were examined at baseline, at year 1 and 2 with measures of pulse wave velocity and arterial augmentation index, as well as echocardiographic evaluation of diastolic parameters and ventricular-arterial coupling...
November 15, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/29141045/csf-in-the-ventricles-of-the-brain-behaves-as-a-relay-medium-for-arteriovenous-pulse-wave-phase-coupling
#14
William E Butler, Pankaj K Agarwalla, Patrick Codd
The ventricles of the brain remain perhaps the largest anatomic structure in the human body without established primary purpose, even though their existence has been known at least since described by Aristotle. We hypothesize that the ventricles help match a stroke volume of arterial blood that arrives into the rigid cranium with an equivalent volume of ejected venous blood by spatially configuring cerebrospinal fluid (CSF) to act as a low viscosity relay medium for arteriovenous pulse wave (PW) phase coupling...
2017: PloS One
https://www.readbyqxmd.com/read/29120452/vascular-aging-and-cardiac-maladaptation-in-growth-restricted-preterm-infants
#15
A Sehgal, B J Allison, S M Gwini, S Menahem, S L Miller, G R Polglase
OBJECTIVE: To assess arterial morphology and mechanics in preterm infants with fetal growth restriction (FGR) compared with those appropriate for gestational age (AGA) in the early neonatal period. STUDY DESIGN: This observational study involved 20 preterm FGR infants (28 to 32 weeks) of gestational age (GA) and birth weight (BW) <10th centile and 20 preterm AGA infants. Vascular ultrasound was performed to measure aortic properties. RESULTS: GA and BW of FGR and AGA infants were 29...
January 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29104545/the-adenosine-hypothesis-revisited-modulation-of-coupling-between-myocardial-perfusion-and-arterial-compliance
#16
Geoffrey P Dobson, Aryadi Arsyad, Hayley L Letson
For over four decades the thoracic aortic ring model has become one of the most widely used methods to study vascular reactivity and electromechanical coupling. A question that is rarely asked, however, is what function does a drug-mediated relaxation (or contraction) in this model serve in the intact system? The physiological significance of adenosine relaxation in rings isolated from large elastic conduit arteries from a wide range of species remains largely unknown. We propose that adenosine relaxation increases aortic compliance in acute stress states and facilitates ventricular-arterial (VA) coupling, and thereby links compliance and coronary artery perfusion to myocardial energy metabolism...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/29080191/computational-analysis-of-the-effect-of-mitral-and-aortic-regurgitation-on-the-function-of-ventricular-assist-devices-using-3d-cardiac-electromechanical-model
#17
Yoo Seok Kim, Ana R Yuniarti, Kwang-Soup Song, Natalia A Trayanova, Eun Bo Shim, Ki Moo Lim
Valvular insufficiency affects cardiac responses and the pumping efficacy of left ventricular assist devices (LVADs) when patients undergo LVAD therapy. Knowledge of the effect of valvular regurgitation on the function of LVADs is important when treating heart failure patients. The goal of this study was to examine the effect of valvular regurgitation on the ventricular mechanics of a heart under LVAD treatment and the pumping efficacy of an LVAD using a computational model of the cardiovascular system. For this purpose, a 3D electromechanical model of failing ventricles in a human heart was coupled with a lumped-parameter model of valvular regurgitation and an LVAD-implanted vascular system...
October 28, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/29058110/computational-prediction-of-the-effects-of-the-intra-aortic-balloon-pump-on-heart-failure-with-valvular-regurgitation-using-a-3d-cardiac-electromechanical-model
#18
Chang-Hyun Kim, Kwang-Soup Song, Natalia A Trayanova, Ki Moo Lim
Intra-aortic balloon pump (IABP) is normally contraindicated in significant aortic regurgitation (AR). It causes and aggravates pre-existing AR while performing well in the event of mitral regurgitation (MR). Indirect parameters, such as the mean systolic pressure, product of heart rate and peak systolic pressure, and pressure-volume are used to quantify the effect of IABP on ventricular workload. However, to date, no studies have directly quantified the reduction in workload with IABP. The goal of this study is to examine the effect of IABP therapy on ventricular mechanics under valvular insufficiency by using a computational model of the heart...
October 23, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/29023250/biomechanical-determinants-of-right-ventricular-failure-in-pulmonary-hypertension
#19
Francesco Scardulla, Diego Bellavia, Patrizio Vitulo, Giuseppe Romano, Chiara Mina, Giovanni Gentile, Francesco Clemenza, Salvatore Pasta
Pulmonary hypertension (PH) is a disease characterized by progressive adverse remodeling of the distal pulmonary arteries, resulting in elevated pulmonary vascular resistance and load pressure on the right ventricle (RV), ultimately leading to RV failure. Invasive hemodynamic testing is the gold standard for diagnosing PH and guiding patient therapy. We hypothesized that lumped-parameter and biventricular finite-element (FE) modeling may lead to noninvasive predictions of both PH-related hemodynamic and biomechanical parameters that induce PH...
October 18, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29019850/ventriculo-arterial-coupling-analysis-predicts-the-hemodynamic-response-to-norepinephrine-in-hypotensive-postoperative-patients-a-prospective-observational-study
#20
Pierre-Grégoire Guinot, Dan Longrois, Said Kamel, Emmanuel Lorne, Hervé Dupont
OBJECTIVES: The objectives of the present study were to evaluate, in patients with persistent arterial hypotension in the immediate postcardiac surgery period, the effects of norepinephrine infusion on ventriculo-arterial coupling, its determinants: arterial elastance and end-systolic ventricular elastance, and to test the ability of arterial elastance to end-systolic ventricular elastance ratio to predict stroke volume increases. DESIGN: Prospective observational study...
January 2018: Critical Care Medicine
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