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Systolic pulmonary venous flow reversal

Amarnath Bhide, Leena Alanne, Juha Rasanen, Heikki Huhta, Juulia Junno, Merja Kokki, Tiina Erkinaro, Pasi Ohtonen, Mervi Haapsamo, Ganesh Acharya
Sildenafil is a potential new treatment for placental insufficiency in human pregnancies as it reduces the breakdown of vasodilator nitric oxide. Pulmonary vasodilatation is observed in normoxemic fetuses following sildenafil administration. Placental insufficiency often leads to fetal hypoxemia that can cause pulmonary vasoconstriction and fetal cardiac dysfunction as evidenced by reduced isovolumic myocardial velocities. We tested the hypotheses that sildenafil, when given directly to the hypoxemic fetus, reverses reactive pulmonary vasoconstriction, increases left ventricular cardiac output by increasing pulmonary venous return, and ameliorates hypoxemic myocardial dysfunction...
January 1, 2018: Reproductive Sciences
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]
Maryam Nabati, Ghasem Janbabai, Saideh Baghyari, Khadige Esmaili, Jamshid Yazdani
PURPOSE: Anthracyclines (ANTs) are a class of active antineoplastic agents with topoisomerase-interacting activity that are considered the most active agents for the treatment of breast cancer. We investigated the efficacy of carvedilol in the inhibition of ANT-induced cardiotoxicity. METHODS: In this randomized, single-blind, placebo-controlled study, 91 women with recently diagnosed breast cancer undergoing ANT therapy were randomly assigned to groups treated with either carvedilol (n = 46) or placebo (n = 45)...
May 2017: Journal of Cardiovascular Pharmacology
A Ammar, K Mahmoud, A Elkersh, Z Kasemy
There is a strong association between pre-operative diastolic dysfunction and difficulty in weaning from cardiopulmonary bypass. We compared the effects of propofol and isoflurane on left ventricular diastolic function in patients with pre-existing diastolic dysfunction undergoing coronary artery bypass grafting. We randomly allocated 60 patients to receive either propofol or isoflurane anaesthesia, and assessed left ventricular diastolic function using transoesophageal echocardiography. We measured early (E), late (A) diastolic velocities, E/A ratio, A-wave duration and deceleration time using pulsed wave Doppler, and early (Em), late (Am) diastolic velocities of the mitral annulus, Em/Am ratio and isovolumetric relaxation time using tissue Doppler...
November 2016: Anaesthesia
Michael R Pinsky
The primary role of the right ventricle (RV) is to deliver all the blood it receives per beat into the pulmonary circulation without causing right atrial pressure to rise. To the extent that it also does not impede left ventricular (LV) filling, cardiac output responsiveness to increased metabolic demand is optimized. Since cardiac output is a function of metabolic demand of the body, during stress and exercise states the flow to the RV can vary widely. Also, instantaneous venous return varies widely for a constant cardiac output as ventilatory efforts alter the dynamic pressure gradient for venous return...
September 10, 2016: Critical Care: the Official Journal of the Critical Care Forum
Peter Wohlfahrt, Slavomir Rokosny, Vojtech Melenovsky, Barry A Borlaug, Vera Pecenkova, Peter Balaz
In patients with end-stage renal disease, excessive blood flow through an arteriovenous fistula (AVF) may lead to volume overload-induced cardiac remodeling and heart failure. It is unclear which patients with hyperfunctional AVF may benefit from AVF reduction or ligation. The indication for the procedure is often based on AVF flow. Because cardiac remodeling is driven by increased venous return, which is equivalent to cardiac output, we hypothesized that an elevated cardiac index (CI) might better identify subjects with reverse remodeling after AVF reduction...
September 2016: Hypertension Research: Official Journal of the Japanese Society of Hypertension
Ankush Sharma, Divya Dahiya, Lileswar Kaman, Vikas Saini, Arunanshu Behera
High intra-abdominal pressure and reverse Trendelenburg position during laparoscopic cholecystectomy (LC) are risk factors for venous stasis in lower extremity. Lower limb venous stasis is one of the major pathophysiological elements involved in the development of peri-operative deep vein thrombosis. Low pressure pneumoperitoneum (7-10 mmHg) has been recommended in patients with limited cardiac, pulmonary or renal reserve. The purpose of this study was to observe the effect of various pneumoperitoneum pressures on femoral vein (FV) hemodynamics during LC...
June 2016: Updates in Surgery
Robert Naeije, Alessandra Manes
Pulmonary arterial hypertension (PAH) is a right heart failure syndrome. In early-stage PAH, the right ventricle tends to remain adapted to afterload with increased contractility and little or no increase in right heart chamber dimensions. However, less than optimal right ventricular (RV)-arterial coupling may already cause a decreased aerobic exercise capacity by limiting maximum cardiac output. In more advanced stages, RV systolic function cannot remain matched to afterload and dilatation of the right heart chamber progressively develops...
December 2014: European Respiratory Review: An Official Journal of the European Respiratory Society
Jing Zhang, Qichang Zhou, Ming Zhang, Qinghai Peng, Shi Zeng, Jiawei Zhou
OBJECTIVE: To discuss the value of fetal pulmonary venous Doppler flow patterns in hypoplastic left heart syndrome (HLHS). METHODS: Forty-six HLHS and 180 normal singleton fetuses at 24+0 to 37+6 weeks of gestation were enrolled in this study. The blood flow of pulmonary vein (PV) was detected by color Doppler ultrasound. The systolic wave of ventricle (S-wave), diastolic wave of ventricle (D-wave), atrial contraction wave (A-wave) and S/D ratio of PV were measured...
June 2014: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Murat Muhtar Yılmazer, Barış Güven, Özgül Vupa-Çilengiroğlu, Taliha Öner, Savaş Demirpençe, Timur Meşe, Vedide Tavlı
We sought to assess the effects of transcatheter closure of atrial septal defect (ASD) on right and left ventricular form and functions, as well as atrial volumes and pulmonary venous flows. We enrolled 25 patients (mean age: 9.02) prospectively who underwent successful transcatheter closure of secundum ASD. We performed transthoracic echocardiography, including two-dimensional, pulsed wave Doppler, M-mode echocardiography, and tissue Doppler imaging before the procedure and 1 day, 1 month, 3 months and 6 months after the procedure...
July 2013: Turkish Journal of Pediatrics
Kenji Baba, Osami Honjo, Rajiv Chaturvedi, Kyong-Jin Lee, Glen Van Arsdell, Christopher A Caldarone, Lee N Benson
OBJECTIVE: Retrograde aortic arch malperfusion after ductal stenting can be life-threatening after univentricular hybrid palliation. Arch perfusion can be maintained with a main pulmonary artery to innominate artery shunt placed during the stage I procedure: a "reverse Blalock-Taussig shunt." METHODS: A retrospective review of 37 infants who underwent hybrid palliation from January 2004 to March 2010 was performed. The infants were divided into 2 groups, those with (group I, n = 16) and those without (group II, n = 21) a reverse Blalock-Taussig shunt...
August 2013: Journal of Thoracic and Cardiovascular Surgery
Karsten Koenigstein, Tanja Raedle-Hurst, Meryem Hosse, Maxi Hauser, Hashim Abdul-Khaliq
We evaluated the interaction of left atrial and ventricular diastolic performance in asymptomatic children and young adults after ToF-repair (n=25). Those young people, as well as 25 age matched healthy children and young adults were examined using non-invasive conventional echocardiography. Regional systolic and diastolic myocardial strain and strain rate in left atrium and ventricle were analysed using 2D-speckle-tracking (Vivid VII, EchoPacGE). We collected planimetric data about the left atrial and ventricular performance during systole (volumetric LVEF, LV-Tei-Index, MV-E/E'-Ratio) and diastole (LAEF, LVEDV, left atrial volume)...
April 2013: Pediatric Cardiology
C Enzensberger, M Vogel, J Degenhardt, N Fass, A Kawecki, T Kohl, E Widriani, R Axt-Fliedner
PURPOSE: Hypoplastic left heart (HLH) with intact or restrictive interatrial communication (HLH-IAS/RAS) is associated with high mortality rates. The object was to correlate pulmonary venous (PV) Doppler spectra and direct foramen ovale (FO) assessment with the neonatal need for early atrial septostomy (EAS) and neonatal outcome. MATERIALS AND METHODS: We reviewed all prenatal echocardiograms and outcomes of 51 fetuses with HLH and information about the interatrial communication between 1994 - 2011...
December 2012: Ultraschall in der Medizin
John W Chu, Gregory T Jones, Gregory P Tarr, L Vicky Phillips, Gerard T Wilkins, Andre M van Rij, Michael J A Williams
BACKGROUND: This study aimed to investigate whether the endogenous active levels of MMP-9 or tissue inhibitor of metalloproteinases-1 (TIMP-1) were related to indices of diastolic dysfunction (DD) in the setting of contemporary treatment of coronary artery disease (CAD). METHODS AND RESULTS: We prospectively studied 116 patients with CAD and preserved left ventricular LV systolic function (ejection fraction ≥ 45%). All patients were free of heart failure symptoms at recruitment and underwent percutaneous intervention (PCI) of culprit lesions...
August 20, 2013: International Journal of Cardiology
Yan Topilsky, Francesco Grigioni, Maurice Enriquez-Sarano
Mitral regurgitation (MR) is the most frequent valve disease. Nevertheless, evaluation of MR severity is difficult because standard color flow imaging is plagued by considerable pitfalls. Modern surgical indications in asymptomatic patients require precise assessment of MR severity. MR severity assessment is always comprehensive, utilizing all views and methods. Determining trivial/mild MR is usually easy, based on small jet and flow convergence. Specific signs of severe MR (pulmonary venous flow systolic reversal or severe mitral lesion) are useful but insensitive...
2011: Seminars in Thoracic and Cardiovascular Surgery
Dan Dan Sun, Hong Mao Chen, Yun You Duan, Li Jun Yuan, Fu Jun Shang, Ning Nan Liang, Wei Cao
We aimed to establish a canine model of acute thromboembolic pulmonary hypertension (ATEPH) and to explore the feasibility of diagnosing pulmonary hypertension (PH) through the Doppler flow spectra of the superior vena cava (SVC). A canine model of ATEPH was developed by infusing thrombus into the right femoral vein. The pulmonary arterial pressure was simultaneously measured via a right heart catheter with the guidance of ultrasound. The maximum systolic peak flow velocity (SPV), ventricular reverse peak flow velocity (VRPV), diastolic peak flow velocity (DPV), and atrial reverse peak flow velocity (ARPV) of the SVC were measured by transthoracic echocardiography...
October 2011: Echocardiography
Yat-Yin Lam, Fang Fang, Gabriel Wai-Kwok Yip, Zhi-An Li, Ya Yang, Cheuk-Man Yu
BACKGROUND: The relation between pulmonary venous flow (PVF) pattern and degree of left-to-right interatrial shunting (IAS) in patients with secundum atrial septal defect (ASD) is unknown. METHODS: Fifty consecutive ASD patients (14 males, 36 ± 17 years) received transthoracic echocardiography (TTE) before and 1 day after transcatheter closure and their results were compared to 40 controls. The ratio of pulmonary-to-systemic flows (Qp/Qs) was assessed by TTE and invasive oximetry...
September 20, 2012: International Journal of Cardiology
J H Suk, K I Cho, S H Lee, H G Lee, S M Kim, T I Kim, M K Kim, Y K Shong
BACKGROUND: Right-sided heart failure with clinical manifestation is only occasionally seen in patients with Graves' disease (GD). Recent studies revealed that pulmonary hypertension (PHT) detected by echocardiography was not rare in patients with GD. We performed this study to investigate the prevalence of PHT in patients with GD before and after antithyroid treatment, and to assess potential mechanisms from the relationship with clinical and echocardiographic features. SUBJECTS AND METHODS: Serial echocardiographic examinations were performed in 64 patients with newly diagnosed GD before and after antithyroid treatment to measure cardiac factors, such as pulmonary artery systolic pressure (PAPs), cardiac output, total vascular resistance, left ventricular filling pressure and right ventricular (RV) function...
September 2011: Journal of Endocrinological Investigation
Kazuya Murata
Pulsed-Doppler derived transmitral flow (TMF) has been widely used for evaluating left ventricular (LV) diastolic function. The grading of LV diastolic dysfunction is feasible by the ratio of early to late diastolic inflow velocities (E/A): normal: E/A > 1, grade I: E/A < 1 (abnormal relaxation pattern), grade II: E/A > 1 (pseudonormal pattern), grade III: E/A > > 1 (restrictive pattern), and grade IV: E/A > > 1 (irreversible restrictive pattern). Pulmonary venous flow pattern is also used for evaluation of LV diastolic dysfunction, especially to differentiate a normal from pseudonormal TMF pattern...
August 2010: Rinsho Byori. the Japanese Journal of Clinical Pathology
Jacek Lelakowski, Adam Dreher, Jacek Majewski, Jacek Bednarek, Mieczysław Pasowicz
INTRODUCTION: The purpose of the present study was to evaluate the effects of RF ablation on parameters of left ventricular (LV) function and exercise capacity in patients with AVRT. MATERIAL AND METHODS: The study population consisted of 24 subjects (10M, 14F), mean age 38.1+/-8.9 years. Subjects over 50 years of age, with concomitant cardiovascular disease and EF<50% were excluded from the study. The following examinations were performed in all patients at baseline and at six months after the procedure: 1) physical examination, 2) standard ECG recording, 3) 24hr Holter monitoring, 4) transthoracic ECHO, 5) treadmill exercise test using the modified Bruce protocol to evaluate exercise duration, peak heart rate and workload achieved...
2009: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
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