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Functional classification of pulmonary. Hypertension

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https://www.readbyqxmd.com/read/28427470/pulmonary-hypertension-in-lymphangioleiomyomatosis-prevalence-severity-and-the-role-of-carbon-monoxide-diffusion-capacity-as-a-screening-method
#1
Carolina S G Freitas, Bruno G Baldi, Carlos Jardim, Mariana S Araujo, Juliana Barbosa Sobral, Gláucia I Heiden, Ronaldo A Kairalla, Rogério Souza, Carlos R R Carvalho
BACKGROUND: Lymphangioleiomyomatosis (LAM) is included within group 5 of the current PH classification (unclear multifactorial mechanisms). However, data regarding the occurrence of PH in LAM are scarce. The aims of the study were to describe the prevalence and characteristics of PH in a large cohort of LAM patients with different levels of severity, and to evaluate the role of echocardiography and carbon monoxide diffusion capacity (DLCO) as screening methods for PH in LAM. METHODS: One hundred five LAM patients underwent transthoracic echocardiography, pulmonary function tests (PFTs) and 6-min walk test (6MWT)...
April 20, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28425226/a-review-of-pediatric-pulmonary-hypertension-with-new-guidelines
#2
Serdar Kula, Ayhan Pektaş
This study aims to review pediatric pulmonary hypertension (PH) by comparing the guidelines of the European Society of Cardiology (ESC)/European Respiratory Society (ERS), the American Heart Association (AHA)/American Thoracic Society (ATS), and the European Pediatric Pulmonary Vascular Disease Network (EPPVDN). All three sets of guidelines define PH as having a mean pulmonary artery pressure of ≥25 mmHg and accept the validity of the World Health Organization (WHO) classification system. Every child with a high index of suspicion for PH should undergo an initial work-up of chest X-rays, electrocardiography, and echocardiography...
April 18, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28301228/the-evolving-classification-of-pulmonary-hypertension
#3
Michelle Foshat, Nahal Boroumand
CONTEXT: - An explosion of information on pulmonary hypertension has occurred during the past few decades. The perception of this disease has shifted from purely clinical to incorporate new knowledge of the underlying pathology. This transfer has occurred in light of advancements in pathophysiology, histology, and molecular medical diagnostics. OBJECTIVES: - To update readers about the evolving understanding of the etiology and pathogenesis of pulmonary hypertension and to demonstrate how pathology has shaped the current classification...
March 16, 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28277870/safety-and-effectiveness-of-tadalafil-in-patients-with-pulmonary-arterial-hypertension-japanese-post-marketing-surveillance-data
#4
Hiroyoshi Yamazaki, Noriko Kobayashi, Masanori Taketsuna, Koyuki Tajima, Masahiro Murakami
OBJECTIVE: To evaluate the long-term safety and effectiveness of tadalafil in patients with pulmonary arterial hypertension (PAH) in real-world clinical practice. METHODS: This prospective, multicenter, noninterventional, post-marketing surveillance included patients with PAH who were observed for up to 2 years after initiation of tadalafil. Safety was assessed by analyzing the frequency of adverse drug reactions (ADRs), discontinuations due to adverse events (AEs), and serious adverse drug reactions (SADRs)...
May 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28119496/treatment-of-pulmonary-arterial-hypertension-using-initial-combination-therapy-of-bosentan-and-iloprost
#5
Xinpeng Han, Yuhai Zhang, Liang Dong, Liying Fang, Yaqin Chai, Mengjie Niu, Yongping Yu, Lingli Liu, Xuemin Yang, Shuoyao Qu, Shengqing Li
BACKGROUND: Monotherapy and sequential combination therapy have been widely used in the treatment of pulmonary arterial hypertension (PAH). There is limited evidence for initial combination therapy in patients with PAH, particularly those with World Health Organization (WHO) functional class III or IV. METHODS: Twenty-seven consecutive treatment-naive PAH subjects with WHO functional class III or IV PAH were randomized into 3 groups with a 1:1:1 ratio: a combination therapy group with 125 mg of bosentan twice daily plus 10 μg of iloprost 4-6 times/d; a bosentan monotherapy group with 125 mg of bosentan twice daily; and a iloprost monotherapy group with 10 μg of iloprost 4-6 times/d...
January 24, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28081353/clinical-correlation-between-the-6-min-walk-test-andcardiopulmonary-exercise-testing-in-patients-with-pulmonary-arterial-hypertension
#6
Serap Acar, Sema Savcı, Didem Kardibak, Buse Özcan Kahraman, Bahri Akdeniz, Ebru Özpelit, Can Sevinç
BACKGROUND/AIM: The aims of the present study were to assess the relationship between the distance walked during the 6-min walk test (6MWT) and exercise capacity as determined by cardiopulmonary exercise testing (CPET) in patients with pulmonary arterial hypertension (PAH) and to investigate the prognostic value of the 6MWT in comparison to clinical parameters of CPET and echocardiography findings. MATERIALS AND METHODS: Thirty PAH patients participated in the study...
December 20, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28077433/osteoprotegerin-disruption-attenuates-hysu-induced-pulmonary-hypertension-through-integrin-%C3%AE-v%C3%AE-3-fak-akt-pathway-suppression
#7
Daile Jia, Qian Zhu, Huan Liu, Caojian Zuo, Yuhu He, Guilin Chen, Ankang Lu
BACKGROUND: Pulmonary arterial remodeling characterized by increased vascular smooth muscle proliferation is commonly seen in life-threatening disease, pulmonary arterial hypertension (PAH). Clinical studies have suggested a correlation between osteoprotegerin serum levels and PAH severity. Here, we aimed to invhestigate vascular osteoprotegerin expression and its effects on pulmonary arterial smooth muscle cell proliferation in vitro and in vivo, as well as examine the signal transduction pathways mediating its activity...
February 2017: Circulation. Cardiovascular Genetics
https://www.readbyqxmd.com/read/27837039/low-risk-for-local-and-systemic-complications-after-primary-repair-of-1626-achilles-tendon-ruptures
#8
Nicholas Rensing, Brian R Waterman, Rachel M Frank, Kenneth A Heida, Justin D Orr
INTRODUCTION: Historically, Achilles tendon repairs and other surgeries about the hindfoot have demonstrated a significantly higher rate of wound healing complications and surgical site morbidity. The purpose of this study was to evaluate the comprehensive complication profile and risk factors for adverse short-term, clinical outcomes after primary repair of Achilles tendon ruptures. METHODS: Between the years 2005 and 2014, all cases of primary Achilles tendon repair (Current Procedural Terminology code 27650) entered into the National Surgical Quality Improvement Project (NSQIP) database were extracted for analysis...
November 10, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27826710/the-action-of-smooth-muscle-cell-potassium-channels-in-the-pathology-of-pulmonary-arterial-hypertension
#9
REVIEW
Yasunobu Hayabuchi
Many different types of potassium channels with various functions exist in pulmonary artery smooth muscle cells, contributing to many physiological actions and pathological conditions. The deep involvement of these channels in the onset and exacerbation of pulmonary arterial hypertension (PAH) also continues to be revealed. In 2013, KCNK3 (TASK1), which encodes a type of two-pore domain potassium channel, was shown to be a predisposing gene for PAH by genetic mutation, and it was added to the PAH classification at the Fifth World Symposium on Pulmonary Hypertension (Nice International Conference)...
January 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/27739097/acute-effect-of-iloprost-inhalation-on-right-atrial-function-and-ventricular-dyssynchrony-in-patients-with-pulmonary-artery-hypertension
#10
Luigi Gabrielli, María Paz Ocaranza, Marta Sitges, Andrés Kanacri, Rodrigo Saavedra, Pablo Sepulveda, Luis Sepulveda, Victor Rossel, Monica Zagolin, Hugo E Verdejo, Fernando Baraona, Ricardo Zalaquett, Mario Chiong, Sergio Lavandero, Pablo F Castro
BACKGROUND: Right atrium function and ventricular function have significant prognostic value in pulmonary arterial hypertension patients. Acute changes in right ventricular synchrony and right atrium function postiloprost inhalation have not been evaluated. METHODS: Cross-sectional study. Consecutive pulmonary arterial hypertension patients (group I from Nice classification) were included. Echocardiographic right atrium and right ventricular function pre- and postiloprost inhalation, including a right ventricular dyssynchrony index and right atrium function using speckle tracking, were performed in all patients...
January 2017: Echocardiography
https://www.readbyqxmd.com/read/27636399/which-type-of-valve-should-we-use-in-tricuspid-position-long-term-comparison-between-mechanical-and-biological-valves
#11
Ana Redondo Palacios, José López Menéndez, Javier Miguelena Hycka, Miren Martín García, Laura Varela Barca, Andrea Ferreiro Marzal, Rafael Muñoz Pérez, Enrique Oliva De Anquín, Ignacio García Andrade, Tomasa Centella Hernández, Daniel Celemín Canorea, Jorge Rodríguez-Roda Stuart
BACKGROUND: Nowadays, Tricuspid valve replacement (TVR) is much less common than aortic or mitral valve replacement, since repair is almost always preferable. Prosthetic tricuspid valves are associated with high mortality and morbidity, mostly due to thrombotic or hemorrhagic events. Nevertheless, there is lack of evidence of which is the optimal type of valve (biological versus mechanical) in tricuspid position. METHODS: We analysed all the patients who underwent TVR in our Institution, from 2005 to 2015...
September 16, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27603702/transthoracic-echocardiography-and-chest-computed-tomography-arteriography-in-patients-with-acute-pulmonary-embolism-a-two-year-follow-up-study
#12
Walter Serra, Ernesto Crisafulli, Nicola Sverzellati, P Tito Ugolotti, Panajota Tzani, Emilio Marangio, Diego Ardissino, Tiziano Gherli, Alfredo Chetta
BACKGROUND: Pulmonary hypertension (PH) is frequently found at the time of diagnosis of pulmonary embolism (PE). An incomplete resolution of PE can lead to chronic thromboembolic pulmonary hypertension (CTPH). Transthoracic echocardiogram (TTE) is the first step to diagnose an abnormality of the pulmonary vasculature. Based on computed tomography (CT), the Qanadli vascular obstruction index has been extensively used to assess acute PE. OBJECTIVES: Our aim was to ascertain whether at the time of diagnosis of an acute PE episode TTE variables and a Qanadli CT index score may be associated with CTPH 2 years later...
2016: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/27541954/non-invasive-diagnosis-of-pulmonary-hypertension-from-lung-doppler-signal-a-proof-of-concept-study
#13
Laurent Godinas, Frédéric Lador, Rachel Schatzberger, Sven Günther, Michael J Segel, Yoram Palti, Ernesto Maisuls, Olivier Sitbon, Gérald Simonneau
Transthoracic Parametric Doppler (TPD) is a novel ultrasound technique recently developed for the investigation of pulmonary blood vessels. Lung Doppler Signals (LDS) recorded from TPD provide information regarding the functional mechanical characteristics of pulmonary blood vessels. We aimed to define the specific profile of LDS generated from TPD imaging in patients with pulmonary hypertension (PH), and to evaluate the diagnostic performance of LDS to detect PH using right heart catheterization (RHC) as gold standard reference...
August 19, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27490592/pulmonary-hypertension
#14
Peter Oishi, Jeffrey R Fineman
OBJECTIVES: To review the clinical classification, diagnosis, and pathophysiology of pulmonary hypertension in children, emphasizing the role of right ventricular function, ventricular interaction, and congenital heart disease in the evolution and progression of disease, as well as management strategies and therapeutic options. DATA SOURCE: MEDLINE, PubMed. CONCLUSIONS: Critically ill children with pulmonary hypertension associated with congenital heart disease are a high-risk population...
August 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27252844/diagnosis-of-pulmonary-hypertension-from-magnetic-resonance-imaging-based-computational-models-and-decision-tree-analysis
#15
Angela Lungu, Andrew J Swift, David Capener, David Kiely, Rod Hose, Jim M Wild
Accurately identifying patients with pulmonary hypertension (PH) using noninvasive methods is challenging, and right heart catheterization (RHC) is the gold standard. Magnetic resonance imaging (MRI) has been proposed as an alternative to echocardiography and RHC in the assessment of cardiac function and pulmonary hemodynamics in patients with suspected PH. The aim of this study was to assess whether machine learning using computational modeling techniques and image-based metrics of PH can improve the diagnostic accuracy of MRI in PH...
June 2016: Pulmonary Circulation
https://www.readbyqxmd.com/read/27149246/the-role-of-an-activity-monitor-in-the-objective-evaluation-of-patients-with-pulmonary-hypertension
#16
Gulfer Okumus, Goksen Kuran Aslan, Orhan Arseven, Gul Ongen, Halim Issever, Esen Kıyan
INTRODUCTION: Patients with pulmonary hypertension (PH) show no symptoms at rest, but symptoms are triggered by physical activities. OBJECTIVES: The primary aim of our study was to assess physical activity of patients with PH by using an activity monitor. The secondary aim was to evaluate the correlation between the activity monitor parameters and 6-minute walk distance (6MWD), activity of daily living (ADL), quality of life, WHO functional class, and PH classification...
May 5, 2016: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/27144613/left-atrial-intrinsic-strain-rate-correcting-for-pulmonary-wedge-pressure-is-accurate-in-estimating-pulmonary-vascular-resistance-in-breathless-patients
#17
Erik Tossavainen, Michael Y Henein, Christer Grönlund, Per Lindqvist
OBJECTIVES: We hypothesized that left atrial deformation during atrial systole (LASRa) correlates with pulmonary capillary wedge pressure (PCWP), thus enabling echo-derived pulmonary vascular resistance (PVR) estimation in a wide range of different subsets of patients. BACKGROUND: Various etiologies of pulmonary hypertension (PH) have different mechanisms and treatments for breathlessness. Irrespective of the location of the underlying pulmonary vascular pathology, pre- or postcapillary, the resulting PH is fairly easy to assess by Doppler echocardiography, but PVR remains a challenge...
August 2016: Echocardiography
https://www.readbyqxmd.com/read/27065171/adhesion-molecules-master-controllers-of-the-circulatory-system
#18
REVIEW
Eric P Schmidt, Wolfgang M Kuebler, Warren L Lee, Gregory P Downey
This manuscript will review our current understanding of cellular adhesion molecules (CAMs) relevant to the circulatory system, their physiological role in control of vascular homeostasis, innate and adaptive immune responses, and their importance in pathophysiological (disease) processes such as acute lung injury, atherosclerosis, and pulmonary hypertension. This is a complex and rapidly changing area of research that is incompletely understood. By design, we will begin with a brief overview of the structure and classification of the major groups of adhesion molecules and their physiological functions including cellular adhesion and signaling...
March 15, 2016: Comprehensive Physiology
https://www.readbyqxmd.com/read/27053692/diagnostics-monitoring-and-outpatient-care-in-children-with-suspected-pulmonary-hypertension-paediatric-pulmonary-hypertensive-vascular-disease-expert-consensus-statement-on-the-diagnosis-and-treatment-of-paediatric-pulmonary-hypertension-the-european-paediatric
#19
Astrid E Lammers, Christian Apitz, Peter Zartner, Alfred Hager, Karl-Otto Dubowy, Georg Hansmann
Pulmonary hypertension (PH) is a condition of multiple aetiologies with underestimated prevalence and incidence. Indeed, despite access to modern therapies, pulmonary hypertensive vascular disease (PHVD) remains a progressive, usually life-limiting condition, severely impacting on the patients' well-being. We herein provide practical, expert consensus recommendations on the initial diagnostic work-up, clinical management and follow-up of children and adolescents with PH/PHVD, including a diagnostic algorithm...
May 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27003666/new-therapeutic-paradigms-and-guidelines-in-the-management-of-pulmonary-arterial-hypertension
#20
REVIEW
Nicholas S Hill, Michael J Cawley, Cherilyn L Heggen-Peay
BACKGROUND: Recent and ongoing developments in the diagnosis, treatment, and management of pulmonary arterial hypertension (PAH) provide deeper insights into pathogenic mechanisms. Approvals of new pharmacotherapies that improve function and reduce morbidity and mortality risks; advances in clinical trial methods, including long-term, event-driven studies with clinically relevant and patient-centered endpoints; and trial results support a new therapeutic management strategy. This new paradigm involves initial treatment with combined therapies that act through different disease pathways...
March 2016: Journal of Managed Care & Specialty Pharmacy
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