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Pulmonary hypertension AND exercise

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https://www.readbyqxmd.com/read/29029950/survival-of-idiopathic-pulmonary-arterial-hypertension-patients-in-the-modern-era-in-australia-and-new-zealand
#1
Geoff Strange, Edmund M Lau, Eleni Giannoulatou, Carolyn Corrigan, Eugene Kotlyar, Fiona Kermeen, Trevor Williams, David S Celermajer, Nathan Dwyer, Helen Whitford, Jeremy P Wrobel, John Feenstra, Melanie Lavender, Kenneth Whyte, Nicholas Collins, Peter Steele, Susanna Proudman, Vivek Thakkar, Dominic Keating, Anne Keogh
BACKGROUND: Epidemiology and treatment strategies continue to evolve in pulmonary arterial hypertension (PAH). We sought to define the characteristics and survival of patients with idiopathic, heritable and drug-induced PAH in the current management era. METHODS: Consecutive cases of idiopathic, heritable and drug-induced PAH were prospectively enrolled into an Australian and New Zealand Registry. RESULTS: Between January 2012 and December 2016, a total of 220 incident cases were enrolled (mean age 57...
September 20, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29029023/comprehensive-evaluation-of-the-effectiveness-and-safety-of-balloon-pulmonary-angioplasty-for-inoperable-chronic-thrombo-embolic-pulmonary-hypertension-long-term-effects-and-procedure-related-complications
#2
Tatsuo Aoki, Koichiro Sugimura, Shunsuke Tatebe, Masanobu Miura, Saori Yamamoto, Nobuhiro Yaoita, Hideaki Suzuki, Haruka Sato, Katsuya Kozu, Ryo Konno, Satoshi Miyata, Kotaro Nochioka, Kimio Satoh, Hiroaki Shimokawa
Aims: Although balloon pulmonary angioplasty (BPA) improves haemodynamics and short-term prognosis in patients with inoperable chronic thrombo-embolic pulmonary hypertension (CTEPH), the long-term effects of BPA, and procedure-related complications remain to be fully elucidated. Methods and results: From July 2009 to October 2016, we performed a total of 424 BPA sessions in 84 consecutive patients with inoperable CTEPH. We used 3D reconstructed computed tomography to determine target lesions of pulmonary arteries and optical computed tomography to select balloon size, if needed...
September 23, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29025749/late-onset-postcapillary-pulmonary-hypertension-in-patients-with-transposition-of-the-great-arteries-and-mustard-or-senning-baffles
#3
Marie-A Chaix, Annie Dore, Lise-Andrée Mercier, François-Pierre Mongeon, François Marcotte, Réda Ibrahim, Anita W Asgar, Azadeh Shohoudi, Fabien Labombarda, Blandine Mondésert, Nancy Poirier, Paul Khairy
BACKGROUND: There is a paucity of data regarding late-onset pulmonary hypertension (PH) in patients with transposition of the great arteries and atrial switch surgery. METHODS AND RESULTS: A retrospective cohort study was conducted on 140 adults with transposition of the great arteries and atrial switch surgery, age 37.3±7.8, 37.1% female, in order to assess the prevalence and characteristics of late-onset PH and explore associated factors. Patients were followed for a median of 32...
October 12, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29025748/compromised-cerebrovascular-regulation-and-cerebral-oxygenation-in-pulmonary-arterial-hypertension
#4
Simon Malenfant, Patrice Brassard, Myriam Paquette, Olivier Le Blanc, Audrey Chouinard, Valérie Nadeau, Philip D Allan, Yu-Chieh Tzeng, Sébastien Simard, Sébastien Bonnet, Steeve Provencher
BACKGROUND: Functional cerebrovascular regulatory mechanisms are important for maintaining constant cerebral blood flow and oxygen supply in heathy individuals and are altered in heart failure. We aim to examine whether pulmonary arterial hypertension (PAH) is associated with abnormal cerebrovascular regulation and lower cerebral oxygenation and their physiological and clinical consequences. METHODS AND RESULTS: Resting mean flow velocity in the middle cerebral artery mean flow velocity in the middle cerebral artery (MCAvmean); transcranial Doppler), cerebral pressure-flow relationship (assessed at rest and during squat-stand maneuvers; analyzed using transfer function analysis), cerebrovascular reactivity to CO2, and central chemoreflex were assessed in 11 patients with PAH and 11 matched healthy controls...
October 12, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29023250/biomechanical-determinants-of-right-ventricular-failure-in-pulmonary-hypertension
#5
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 11, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29022270/exercise-training-in-pulmonary-hypertension-and-right-heart-failure-insights-from-pre-clinical-studies
#6
Daniel Moreira-Gonçalves, Rita Ferreira-Nogueira, Mário Santos, Ana Filipa Silva, Rita Ferreira, Adelino Leite-Moreira, José Alberto Duarte, Tiago Henriques-Coelho
Exercise training (ExT) is widely used for the prevention and treatment of several chronic cardiovascular diseases. However, only recently it started to be recognized as safe and beneficial in pulmonary arterial hypertension. Despite the consistency of its favorable effects on exercise tolerance and quality of life, the mechanisms underlying these meaningful clinical improvements remain unclear. Current studies emphasize the exercise-induced changes on skeletal muscle but the impact of ExT at the level of the pulmonary circulation and right ventricle should not be overlooked...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28992168/pulmonary-hypertension-related-to-systemic-sclerosis-points-to-consider-for-clinical-trials
#7
REVIEW
Marc Humbert, Manjit Singh, Daniel E Furst, Dinesh Khanna, James R Seibold
There are proven successful approaches to clinical trial design in pulmonary arterial hypertension (PAH), which in turn have led to the licensing of a number of effective therapies. SSc has been included in trials of World Health Organization Group 1 PAH but has been under-represented. Responses in outcomes as diverse as exercise capacity, quality of life, durability of drug effect and survival have been reduced in comparison with those seen in idiopathic PAH. The PAH community has achieved international and interdisciplinary consensus guidelines for future studies...
September 1, 2017: Rheumatology
https://www.readbyqxmd.com/read/28986358/pulmonary-vasodilation-by-phosphodiesterase-5-inhibition-is-enhanced-and-nitric-oxide-independent-in-early-pulmonary-hypertension-after-myocardial-infarction
#8
Richard W B van Duin, Birgit Houweling, Andre Uitterdijk, Dirk J Duncker, Daphne Merkus
Myocardial infarction (MI) may result in pulmonary hypertension (PH). Inhibition of phosphodiesterase 5 (PDE5), the enzyme responsible for the breakdown of cGMP in vascular smooth muscle, has become part of the contemporary therapeutic armamentarium for pulmonary arterial hypertension and may also be of benefit in PH secondary to MI. Nitric oxide (NO) is an important source of cGMP and can be enhanced in early PH and decreased in severe PH. In the present study we investigated if PDE5-inhibition ameliorates pulmonary hemodynamics in swine with PH secondary to MI and whether NO is essential...
October 6, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28966315/prognostic-value-of-pulmonary-artery-compliance-in-patients-with-pulmonary-arterial-hypertension-associated-with-adult-congenital-heart-disease
#9
Xiao-Ling Cheng, Zhi-Hong Liu, Qing Gu, Xin-Hai Ni, Qin Luo, Zhi-Hui Zhao, Jian-Guo He, Chang-Ming Xiong
In congenital heart disease (CHD), the presence of pulmonary arterial hypertension (PAH) is associated with a poor prognosis. In this study, we aim to investigate the role of pulmonary artery compliance (Cp) in predicting the mortality of PAH associated with adult congenital heart disease (APAH-CHD). One-hundred and seventy-five patients ofAPAH-CHD who underwent a comprehensive clinical evaluation were included in this study. All patients were followed up in a 6-month interval and the primary end point was all cause of death...
September 30, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28957537/the-overloaded-right-heart-and-ventricular-interdependence
#10
Robert Naeije, Roberto Badagliacca
The right and the left ventricle are interdependent as both structures are nested within the pericardium, have the septum in common and are encircled with common myocardial fibres. Therefore, right ventricular volume or pressure overloading affects left ventricular function, and this in turn may affect the right ventricle. In normal subjects at rest, right ventricular function has negligible interaction with left ventricular function. However, the right ventricle contributes significantly to the normal cardiac output response to exercise...
October 1, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/28957534/combining-computer-modelling-and-cardiac-imaging-to-understand-right-ventricular-pump-function
#11
John Walmsley, Wouter van Everdingen, Maarten J Cramer, Frits W Prinzen, Tammo Delhaas, Joost Lumens
Right ventricular (RV) dysfunction is a strong predictor of outcome in heart failure and is a key determinant of exercise capacity. Despite these crucial findings, the RV remains understudied in the clinical, experimental, and computer modelling literature. This review outlines how recent advances in using computer modelling and cardiac imaging synergistically help to understand RV function in health and disease. We begin by highlighting the complexity of interactions that make modelling the RV both challenging and necessary, and then summarize the multiscale modelling approaches used to date to simulate RV pump function in the context of these interactions...
October 1, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/28947033/efficacy-and-safety-of-long-term-imatinib-therapy-for-patients-with-pulmonary-veno-occlusive-disease-and-pulmonary-capillary-hemangiomatosis
#12
Aiko Ogawa, Katsumasa Miyaji, Hiromi Matsubara
BACKGROUND: Pulmonary veno-occlusive disease (PVOD) and pulmonary capillary hemangiomatosis (PCH) are categorized as Group 1' in the clinical classification of pulmonary hypertension. No medical therapy has been proven to be effective in patients with PVOD/PCH. Imatinib is a molecular targeted drug and was expected to be effective in patients with pulmonary arterial hypertension. We evaluated its efficacy and safety in patients with PVOD/PCH. METHODS: In the present observational study, 9 patients with PVOD/PCH received imatinib...
October 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28937582/design-of-the-exercise-mri-evaluation-of-hiv-pulmonary-arterial-hypertension-longitudinal-determinants-exhalted-trial
#13
Mohamad Amer Alaiti, Aditya Goud, Gautam Ramani, Sashwatee Bagchi, Sadeer Al-Kindi, Steven Sawicki, Christopher Longenecker, Trevor Jenkins, David Pauza, Myung Park, Grace McComsey, Orlando Simonetti, Brian Hoit, Sanjay Rajagopalan
BACKGROUND: Pulmonary arterial hypertension (PAH) is a potentially serious cause of dyspnea and exercise limitation in patients with HIV infection. In this trial, we propose using exercise MRI in conjunction with cardiopulmonary testing to delineate PAH from other causes of cardiovascular dysfunction, identify individuals with exercise-induced PAH who are at high risk of developing resting PAH, and provide longitudinal estimates of progression of PAH and right ventricular function. METHODS: In this prospective observational study, HIV patients with dyspnea and exercise limitation in the absence of identifiable causes and those who meet the inclusion criteria will be enrolled based on resting pulmonary artery pressure (≤ or >40 mmHg) on a screening echocardiogram and exercise limitation on the Modified Medical Research Council dyspnea scale...
September 20, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28935040/cardiopulmonary-exercise-testing-what-is-its-value
#14
REVIEW
Marco Guazzi, Francesco Bandera, Cemal Ozemek, David Systrom, Ross Arena
Compared with traditional exercise tests, cardiopulmonary exercise testing (CPET) provides a thorough assessment of exercise integrative physiology involving the pulmonary, cardiovascular, muscular, and cellular oxidative systems. Due to the prognostic ability of key variables, CPET applications in cardiology have grown impressively to include all forms of exercise intolerance, with a predominant focus on heart failure with reduced or with preserved ejection fraction. As impaired cardiac output and peripheral oxygen diffusion are the main determinants of the abnormal functional response in cardiac patients, invasive CPET has gained new popularity, especially for diagnosing early heart failure with preserved ejection fraction and exercise-induced pulmonary hypertension...
September 26, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28929528/a-quality-control-exercise-in-the-echo-laboratory-reduction-in-inter-observer-variability-in-the-interpretation-of-pulmonary-hypertension
#15
Daniel M Patton, Atoosa Enzevaie, Andrew Day, Anthony Sanfilippo, Amer M Johri
BACKGROUND: Right ventricular systolic pressure (RVSP) estimated by echocardiography is critical for the initial screening and follow-up of pulmonary hypertension (PH). Inter-observer variability (IOV) in RVSP can impact clinical decision making. This study assessed whether a simple guideline-based teaching intervention could reduce the IOV in RVSP interpretation. METHODS AND RESULTS: Eleven participants in a high-volume tertiary level echocardiography laboratory underwent an assessment of the baseline IOV in the assessment of RVSP for a series of transthoracic echocardiograms (TTE), depicting various degrees of PH among 8 cases each before and after a teaching intervention...
September 19, 2017: Echocardiography
https://www.readbyqxmd.com/read/28918335/modern-diagnosis-of-chronic-thromboembolic-pulmonary-hypertension
#16
Aileen Kharat, Anne-Lise Hachulla, Stéphane Noble, Frédéric Lador
Chronic thromboembolic pulmonary hypertension (CTEPH) should be suspected in patients presenting persistent dyspnea three months after a pulmonary embolism or in patients presenting with acute pulmonary embolism and suggestive images on the CT-scan. For these patients, a specific diagnostic work-up should be performed. First step consists of the ventilation/perfusion (V/Q) scan which is a good screening test due to its high sensitivity and high negative predictive value. Pulmonary angiography remains the gold standard approach for the confirmation of the diagnosis and pre-surgical evaluation of CTEPH...
September 9, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28912263/hemodynamic-phenotyping-of-pulmonary-hypertension-in-left-heart-failure
#17
REVIEW
Robert Naeije, Mario Gerges, Jean-Luc Vachiery, Sergio Caravita, Christian Gerges, Irene M Lang
Increased pulmonary venous pressure secondary to left heart disease is the most common cause of pulmonary hypertension (PH). The diagnosis of PH due to left heart disease relies on a clinical probability assessment followed by the invasive measurements of a mean pulmonary artery pressure (PAP) ≥25 mm Hg and mean wedged PAP (PAWP) >15 mm Hg. A combination of mean PAP and mean PAWP defines postcapillary PH. Postcapillary PH is generally associated with a diastolic pulmonary pressure gradient (diastolic PAP minus mean PAWP) <7 mm Hg, a transpulmonary pressure gradient (mean PAP minus mean PAWP) <12 mm Hg, and pulmonary vascular resistance ≤3 Wood units (WU)...
September 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28911936/exercise-training-in-patients-with-pulmonary-and-systemic-hypertension-a-unique-therapy-for-two-different-diseases
#18
REVIEW
Massimo Leggio, Augusto Fusco, Giorgio Limongelli, Luca Sgorbini
Pulmonary hypertension is a potentially life-threatening condition. Given its evolving definition, the incidence and prevalence of the disease is difficult to define, but registries suggest an increased global awareness. The management of patients with pulmonary arterial hypertension is highly specialised and requires multi-disciplinary input from a range of healthcare professionals, including cardiologists, respiratory physicians, rheumatologists, rehabilitation physicians and cardio-pulmonary physiotherapists...
September 11, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28911810/exercise-ve-vco2-slope-an-endurance-marker-of-prognosis-in-patients-with-hfpef-and-pulmonary-hypertension-at-least
#19
EDITORIAL
Marco Guazzi
No abstract text is available yet for this article.
September 11, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28910330/quality-of-life-measures-predict-cardiovascular-health-and-physical-performance-in-chronic-renal-failure-patients
#20
A Rogan, K McCarthy, G McGregor, T Hamborg, G Evans, S Hewins, N Aldridge, S Fletcher, N Krishnan, R Higgins, D Zehnder, S M Ting
BACKGROUND: Patients with advanced chronic kidney disease (CKD) experience complex functional and structural changes of the cardiopulmonary and musculoskeletal system. This results in reduced exercise tolerance, quality of life and ultimately premature death. We investigated the relationship between subjective measures of health related quality of life and objective, standardised functional measures for cardiovascular and pulmonary health. METHODS: Between April 2010 and January 2013, 143 CKD stage-5 or CKD5d patients (age 46...
2017: PloS One
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