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Pulmonary hypertension AND exercise

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https://www.readbyqxmd.com/read/28722077/invasive-haemodynamic-evaluation-of-the-pulmonary-circulation-in-pulmonary-hypertension
#1
Alberto Pagnamenta, Andrea Azzola, Maurice Beghetti, Frédéric Lador, On Behalf Of The Swiss Society Of Pulmonary Hypertension
The term pulmonary hypertension refers to a serious condition characterised by high pulmonary vascular pressure, mainly as a consequence of various cardiac and respiratory diseases. Current clinical classification of pulmonary hypertension considers five distinct groups. Transthoracic echocardiography represents the first and most important noninvasive screening tool for estimating the probability of pulmonary hypertension. The diagnostic approach to pulmonary hypertension is supported by a proposed algorithm, which identifies the underlying cause...
July 19, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28705939/changes-in-pulmonary-exercise-haemodynamics-in-scleroderma-a-4-year-prospective-study
#2
Gabor Kovacs, Alexander Avian, Nora Wutte, Franz Hafner, Florentine Moazedi-Fürst, Sonja Kielhauser, Elisabeth Aberer, Marianne Brodmann, Winfried Graninger, Vasile Foris, Andrea Olschewski, Horst Olschewski
Pulmonary arterial hypertension (PAH) is a feared complication of systemic sclerosis. In this prospective cohort study, we monitored the changes in resting and exercise pulmonary haemodynamics of scleroderma patients without initial PAH over a mean follow-up period of ∼4 years.All patients underwent exercise echocardiography and cardiopulmonary exercise testing at baseline and follow-up. A subgroup underwent exercise right heart catheter (RHC) investigations. The primary end-point was the echocardiographic systolic pulmonary arterial pressure at 50 W exercise (sPAP50)...
July 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28695558/rehabilitation-in-patients-with-pulmonary-arterial-hypertension
#3
Stephan Keusch, Alexander Turk, Stéphanie Saxer, Nicola Ehlken, Ekkehard Grunig, Silvia Ulrich, On Behalf Of The Swiss Society Of Pulmonary Hypertension
Exertional dyspnoea is a leading symptom in patients with pulmonary arterial hypertension (PAH). Patients suffering from PAH report poor quality of life, have skeletal muscle dysfunction and in the absence of advanced medical therapy deteriorate progressively due to right heart failure which can lead to death. For decades, patients with PAH were advised to avoid exercise in fear of exacerbated right heart failure. Recently, it has been shown that a highly supervised rehabilitation programme in expert centres leads to significant improvements in symptoms, quality of life, exercise capacity and may even enhance haemodynamics in selected stable patients treated with advanced regimens of PAH-targeted drugs...
July 11, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28694397/-effect-of-disease-severity-on-upper-extremity-muscle-strength-exercise-capacity-and-activities-of-daily-living-in-individuals-with-pulmonary-arterial-hypertension
#4
Buse Özcan Kahraman, İsmail Özsoy, Serap Acar, Ebru Özpelit, Bahri Akdeniz, Can Sevinç, Sema Savcı
OBJECTIVE: Pulmonary arterial hypertension (PAH) is a rare disease. Although muscle strength, exercise capacity, quality of life, and activities of daily living of patients with PAH are affected, it is not known how they are affected by disease severity. The purpose of the present study was to investigate effects of disease severity on upper extremity muscle strength, exercise capacity, and performance of activities of daily living in patients with PAH. METHODS: Twenty-five patients with disease severity classified according to the New York Heart Association (NYHA) as functional class II (n=14) or class III (n=11) were included in the study...
July 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28683960/arterial-stiffening-with-exercise-in-patients%C3%A2-with-heart-failure-and-preserved%C3%A2-ejection-fraction
#5
Yogesh N V Reddy, Mads J Andersen, Masaru Obokata, Katlyn E Koepp, Garvan C Kane, Vojtech Melenovsky, Thomas P Olson, Barry A Borlaug
BACKGROUND: Aortic stiffening and reduced nitric oxide (NO) availability may contribute to the pathophysiology of heart failure with preserved ejection fraction (HFpEF). OBJECTIVES: This study compared indices of arterial stiffness at rest and during exercise in subjects with HFpEF and hypertensive control subjects to examine their relationships to cardiac hemodynamics and determine whether exertional arterial stiffening can be mitigated by inorganic nitrite. METHODS: A total of 22 hypertensive control subjects and 98 HFpEF subjects underwent hemodynamic exercise testing with simultaneous expired gas analysis to measure oxygen consumption...
July 11, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28680584/use-of-thermodilution-cardiac-output-overestimates-diagnoses-of-exercise-induced-pulmonary-hypertension
#6
Steven Hsu, Samuel B Brusca, Parker S Rhodes, Todd M Kolb, Stephen C Mathai, Ryan J Tedford
Two new definitions of exercise-induced pulmonary hypertension (EIPH) have emerged. Both rely on measuring cardiac output (CO), yet this remains unstandardized. In our cohort of patients undergoing invasive cardiopulmonary exercise testing, we found that using thermodilution CO rather than direct Fick CO led to a significant excess of EIPH diagnoses.
March 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28680574/chronic-use-of-pah-specific-therapy-in-world-health-organization-group-iii-pulmonary-hypertension-a-systematic-review-and-meta-analysis
#7
Kurt W Prins, Sue Duval, Jeremy Markowitz, Marc Pritzker, Thenappan Thenappan
Pulmonary hypertension (PH) complicating chronic obstructive pulmonary disease (COPD-PH) and interstitial lung disease (ILD-PH) (World Health Organization [WHO] Group III PH) increases medical costs and reduces survival. Despite limited data, many clinicians are using pulmonary arterial hypertension (PAH)-specific therapy to treat WHO Group III PH patients. To further investigate the utility of PAH-specific therapy in WHO Group III PH, we performed a systematic review and meta-analysis. Relevant studies from January 2000 through May 2016 were identified in the MEDLINE, EMBASE, and COCHRANE electronic databases and www...
March 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28680573/treatment-response-in-patients-with-idiopathic-pulmonary-arterial-hypertension-and-a-severely-reduced-diffusion-capacity
#8
Cathelijne E van der Bruggen, Onno A Spruijt, Esther J Nossent, Pia Trip, J Tim Marcus, Frances S de Man, Harm Jan Bogaard, Anton Vonk Noordegraaf
Patients with idiopathic pulmonary arterial hypertension (IPAH) and a reduced diffusion capacity of the lung for carbon monoxide (DLCO) have a worse survival compared to IPAH patients with a preserved DLCO. Whether this poor survival can be explained by unresponsiveness to pulmonary hypertension (PH)-specific vasodilatory therapy is unknown. Therefore, the aim of this study was to evaluate the hemodynamic and cardiac response to PH-specific vasodilatory therapy in patients with IPAH and a reduced DLCO. Retrospectively, we studied treatment naïve hereditary and IPAH patients diagnosed between January 1990 and May 2015 at the VU University Medical Center...
March 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28680563/effects-of-exercise-training-on-pulmonary-hemodynamics-functional-capacity-and-inflammation-in-pulmonary-hypertension
#9
REVIEW
Manuel J Richter, Jan Grimminger, Britta Krüger, Hossein A Ghofrani, Frank C Mooren, Henning Gall, Christian Pilat, Karsten Krüger
Pulmonary hypertension (PH) is characterized by severe exercise limitation mainly attributed to the impairment of right ventricular function resulting from a concomitant elevation of pulmonary vascular resistance and pressure. The unquestioned cornerstone in the management of patients with pulmonary arterial hypertension (PAH) is specific vasoactive medical therapy to improve pulmonary hemodynamics and strengthen right ventricular function. Nevertheless, evidence for a beneficial effect of exercise training (ET) on pulmonary hemodynamics and functional capacity in patients with PH has been growing during the past decade...
March 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28676038/efficacy-and-safety-of-oral-sildenafil-in-children-with-down-syndrome-and-pulmonary-hypertension
#10
Maurice Beghetti, Andrzej Rudzinski, Min Zhang
BACKGROUND: Despite the increased risk for pulmonary hypertension in children with Down syndrome, the response to treatment with targeted therapies for pulmonary hypertension in these patients is not well characterized. The Sildenafil in Treatment-naive children, Aged 1-17 years, with pulmonary arterial hypertension (STARTS-1) trial was a dose-ranging study of the short-term efficacy and safety of oral sildenafil in children with pulmonary arterial hypertension. We assessed the safety and efficacy of oral sildenafil in children with Down syndrome and pulmonary arterial hypertension...
July 4, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28671932/associations-of-exercise-tolerance-with-hemodynamic-parameters-for-pulmonary-arterial-hypertension-and-for-chronic-thromboembolic-pulmonary-hypertension
#11
Yasunori Tsuboi, Hidekazu Tanaka, Ryo Nishio, Takuma Sawa, Daisuke Terashita, Kazuhiko Nakayama, Seimi Satomi-Kobayashi, Yoshitada Sakai, Noriaki Emoto, Ken-Ichi Hirata
PURPOSE: Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are the main subgroups of pulmonary hypertension (PH). Despite differences in their etiologies, both diseases are characterized by vascular remodeling, resulting in progressive right heart failure. Noninvasive periodic evaluation of exercise tolerance has become increasingly important. Cardiopulmonary exercise testing (CPET) and a 6-minute walk test (6MWT) are now both recommended for evaluating exercise tolerance, but there is insufficient knowledge about possible differences in the associations of exercise tolerance with right heart catheterization (RHC) data for patients with PAH and CTEPH...
June 30, 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/28666992/oxygen-uptake-efficiency-slope-predicts-poor-outcome-in-patients-with-idiopathic-pulmonary-arterial-hypertension
#12
Yi Tang, Qin Luo, Zhihong Liu, Xiuping Ma, Zhihui Zhao, Zhiwei Huang, Liu Gao, Qi Jin, Changming Xiong, Xinhai Ni
BACKGROUND: Few published studies have evaluated the power of the oxygen uptake efficiency slope (OUES) to predict outcomes in patients with idiopathic pulmonary arterial hypertension (IPAH), who typically die of right-sided heart failure. Our study sought to evaluate the power of OUES to predict clinical worsening and mortality in patients with IPAH. METHODS AND RESULTS: Patients with newly diagnosed IPAH who underwent symptom-limited cardiopulmonary exercise testing from November 11, 2010, to June 25, 2015, in our hospital were prospectively enrolled and followed for up to 66 months...
June 30, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28666570/dead-space-ventilation-is-linked-to-exercise-capacity-and-survival-in-distal-chronic-thromboembolic-pulmonary-hypertension
#13
Laurent Godinas, Caroline Sattler, Edmund M Lau, Xavier Jaïs, Yu Taniguchi, Mitja Jevnikar, Jason Weatherald, Olivier Sitbon, Laurent Savale, David Montani, Gérald Simonneau, Marc Humbert, Pierantonio Laveneziana, Gilles Garcia
BACKGROUND: Cardiopulmonary exercise testing (CPET) is frequently used for the evaluation of patients with pulmonary hypertension (PH). Non-operable distal chronic thromboembolic pulmonary hypertension (CTEPH) represents a unique subgroup of PH where microvascular disease resembling pulmonary arterial hypertension (PAH) may predominate and efficacious medical therapy is now available. However, little is known regarding the detailed CPET profile of patients with distal CTEPH, and whether ventilation and gas exchange responses are different from PAH...
May 22, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28664665/imaging-the-right-heart-pulmonary-circulation-unit-insights-from-advanced-ultrasound-techniques
#14
REVIEW
Francesco Ferrara, Luna Gargani, Ellen Ostenfeld, Michele D'Alto, Jaroslaw Kasprzak, Damien Voilliot, Christine Selton-Suty, Olga Vriz, Alberto M Marra, Paola Argiento, Anna A Stanziola, Antonio Cittadini, Antonello D'Andrea, Eduardo Bossone
The right heart pulmonary circulation unit (RH-PCU) is a key determinant of prognosis in several cardiorespiratory diseases. Although right heart catheterization is considered the gold standard for pulmonary hemodynamic assessment, a comprehensive cardiovascular ultrasound approach is an essential step in the diagnostic-prognostic clinical pathway of patients with suspect or overt pulmonary hypertension. The exponential development of advanced ultrasound techniques (strain, 3-dimensional echocardiography and lung ultrasound) has led to new insights into the evaluation of RH-PCU structure and function, overcoming some limitations of standard Doppler echocardiography...
June 29, 2017: Echocardiography
https://www.readbyqxmd.com/read/28650277/attenuated-post-exercise-heart-rate-recovery-in-patients-with-systemic-lupus-erythematosus-the-role-of-disease-severity-and-beta-blocker-treatment
#15
P Bienias, M Ciurzyński, A Chrzanowska, I Dudzik-Niewiadomska, K Irzyk, K Oleszek, A Kalińska-Bienias, B Kisiel, W Tłustochowicz, P Pruszczyk
Objective Sinus tachycardia is frequently reported in systemic lupus erythematosus (SLE), while there are limited data on post-exercise ability to slow heart rate (i.e. heart rate recovery, HRR) in this group of patients. Methods We studied consecutive 70 patients with SLE and 30 healthy controls. All examined individuals underwent detailed clinical examination, echocardiography, Holter monitoring with heart rate variability and treadmill stress test using Bruce's protocol. HRR values were calculated as the difference between maximum HR during exercise and HR at the first (HRR1) and third (HRR3) minute of rest...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28610669/riociguat-for-pulmonary-arterial-hypertension-and-chronic-thromboembolic-pulmonary-hypertension-results-from-a-phase-ii-long-term-extension-study
#16
Michael Halank, Marius M Hoeper, Hossein-Ardeschir Ghofrani, F Joachim Meyer, Gerd Stähler, Jürgen Behr, Ralf Ewert, Monique Fletcher, Pablo Colorado, Sylvia Nikkho, Friedrich Grimminger
BACKGROUND: Riociguat was well tolerated and improved exercise and functional capacity in patients with pulmonary arterial hypertension (PAH) and inoperable chronic thromboembolic pulmonary hypertension (CTEPH) in a 12-week Phase II trial. We present final data from the long-term extension phase of this study. METHODS: During this multicenter, open-label, uncontrolled long-term extension study, riociguat dose could be changed at the physician's discretion (range 0...
July 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28606655/mortality-in-pulmonary-arterial-hypertension-due-to-congenital-heart-disease-serial-changes-improve-prognostication
#17
M T U Schuijt, I M Blok, A H Zwinderman, A C M J van Riel, M J Schuuring, R J de Winter, A L Duijnhouwer, A P J van Dijk, B J M Mulder, B J Bouma
BACKGROUND: Adult patients with pulmonary arterial hypertension due to congenital heart disease (PAH-CHD) suffer from high mortality. This underlines the importance of adequate risk stratification to guide treatment decisions. Several baseline parameters are associated with mortality, however, their prognostic value may weaken after years of follow-up. Therefore we investigated the prognostic value of serial changes in standard clinical parameters in PAH-CHD. METHODS: In this prospective observational cohort study we included consecutive PAH-CHD adults, between 2005 and 2016...
June 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28597780/novel-approach-to-classifying-patients-with-pulmonary-arterial-hypertension-using-cluster-analysis
#18
Kishan S Parikh, Youlan Rao, Tariq Ahmad, Kai Shen, G Michael Felker, Sudarshan Rajagopal
Pulmonary arterial hypertension (PAH) patients have distinct disease courses and responses to treatment, but current diagnostic and treatment schemes provide limited insight. We aimed to see if cluster analysis could distinguish clinical phenotypes in PAH. An unbiased cluster analysis was performed on 17 baseline clinical variables of PAH patients from the FREEDOM-M, FREEDOM-C, and FREEDOM-C2 randomized trials of oral treprostinil versus placebo. Participants were either treatment-naïve (FREEDOM-M) or on background therapy (FREEDOM-C, FREEDOM-C2)...
April 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28597774/combination-therapy-in-pulmonary-arterial-hypertension-recent-accomplishments-and-future-challenges
#19
Annie-Christine Lajoie, Sebastien Bonnet, Steeve Provencher
Pulmonary arterial hypertension (PAH) is a life-threatening disease characterized by a progressive increase in pulmonary vascular resistance, ultimately leading to right heart failure and death. Throughout the past 20 years, numerous specific pharmacologic agents, including phosphodiesterase-5 inhibitors, endothelin receptor antagonists, prostaglandins, and more recently, soluble guanylate cyclase stimulators and selective IP prostacyclin receptor agonist, have emerged for the treatment of PAH. Early clinical trials were typically of short-term duration, comparing the effects of PAH-targeted therapies versus placebo and using exercise tolerance as the primary endpoint in most trials...
April 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28597763/open-label-study-of-ambrisentan-in-patients-with-exercise-pulmonary-hypertension
#20
Sergio A Segrera, Laurie Lawler, Alexander R Opotowsky, David Systrom, Aaron B Waxman
A growing body of evidence suggests that exercise pulmonary hypertension (ePH) is an early form of pulmonary arterial hypertension (PAH). Identifying the disease at an early, potentially more responsive phase, and initiating treatment may improve functional status and prevent progression to severe forms of PAH. This was a single-center, open-label six-month treatment trial to evaluate the effect of ambrisentan on pulmonary hemodynamics and exercise capacity in ePH utilizing invasive cardiopulmonary exercise testing (iCPET)...
April 2017: Pulmonary Circulation
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