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Pulmonary hypertension AND exercise

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https://www.readbyqxmd.com/read/28315502/the-effect-of-left-ventricular-assist-device-therapy-in-patients-with-heart-failure-and-mixed-pulmonary-hypertension
#1
Hoong S Lim, Neil Howell, Aaron Ranasinghe
BACKGROUND: Diastolic pressure gradient (DPG) of ≥7 mmHg has been proposed to distinguish mixed pulmonary hypertension from isolated post-capillary pulmonary hypertension in heart failure (HF). We evaluated the changes in pulmonary hemodynamics with left ventricular assist devices (LVADs) in patients with DPG of ≥7 or <7 mmHg, and effects on peak oxygen uptake (VO2) in patients with advanced HF. METHODS: Pre- and post-LVAD implant pulmonary hemodynamics (including right atrial (RA) pressures, DPG, pulmonary vascular resistance (PVR), pulmonary capacitance (PCap) and cardiac output), echocardiography, cardiopulmonary exercise test were measured in 38 consecutive patients...
March 16, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28298387/diagnosis-of-chronic-thromboembolic-pulmonary-hypertension
#2
REVIEW
Deepa Gopalan, Marion Delcroix, Matthias Held
Chronic thromboembolic pulmonary hypertension (CTEPH) is the only potentially curable form of pulmonary hypertension. Rapid and accurate diagnosis is pivotal for successful treatment. Clinical signs and symptoms can be nonspecific and risk factors such as history of venous thromboembolism may not always be present. Echocardiography is the recommended first diagnostic step. Cardiopulmonary exercise testing is a complementary tool that can help to identify patients with milder abnormalities and chronic thromboembolic disease, triggering the need for further investigation...
January 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/28291667/medical-therapy-versus-balloon-angioplasty-for-cteph-a-systematic-review-and-meta-analysis
#3
Kevin Phan, Helen E Jo, Joshua Xu, Edmund M Lau
BACKGROUND: A significant number of chronic thromboembolic pulmonary hypertension (CTEPH) patients will have an inoperable disease. Medical therapy and balloon pulmonary angioplasty (BPA) have provided alternate therapeutic options for patients with inoperable CTEPH, although there are a limited number of published studies examining the outcomes. Thus, our study aims to evaluate and compare the efficacy of medical therapy and BPA in patients with inoperable CTEPH. METHODS: An electronic search of six databases was performed and the search results were screened against established criteria for inclusion into this study...
March 1, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28290006/exercise-testing-and-stress-imaging-in-mitral-valve-disease
#4
REVIEW
Damien Voilliot, Patrizio Lancellotti
Mitral valve disease represented by mitral stenosis and mitral regurgitation is the second most frequent valvulopathy. Mitral stenosis leads to an increased left atrial pressure whereas mitral regurgitation leads to an increased left atrial pressure associated with a volume overload. Secondary to an upstream transmission of this overpressure, both mitral stenosis and regurgitation lead to pulmonary hypertension and right heart failure. In addition, mitral regurgitation also leads to left ventricular dilatation and dysfunction with left heart failure...
March 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28287506/assessment-of-pulmonary-capillary-blood-volume-membrane-diffusing-capacity-and-intrapulmonary-arteriovenous-anastomoses-during-exercise
#5
Vincent Tedjasaputra, Sean van Diepen, Sophie É Collins, Wade M Michaelchuk, Michael K Stickland
Exercise is a stress to the pulmonary vasculature. With incremental exercise, the pulmonary diffusing capacity (DLCO) must increase to meet the increased oxygen demand; otherwise, a diffusion limitation may occur. The increase in DLCO with exercise is due to increased capillary blood volume (Vc) and membrane diffusing capacity (Dm). Vc and Dm increase secondary to the recruitment and distension of pulmonary capillaries, increasing the surface area for gas exchange and decreasing pulmonary vascular resistance, thereby attenuating the increase in pulmonary arterial pressure...
February 20, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28286762/the-correlation-of-decreased-heart-rate-recovery-and-chronotropic-incompetence-with-exercise-capacity-in-idiopathic-pulmonary-arterial-hypertension-patients
#6
Changwei Wu, Jian Guo, Hui Liu, Bigyan Pudasaini, Wenlan Yang, Qinhua Zhao, Lan Wang, Jinming Liu
We show by this study that a decrease in HRR1 in IPAH patients is associated with severe limitation of exercise capacity. HRR1 < 16 beats and CI just after completion of a CPET could be an indicator of poor prognosis.
2017: BioMed Research International
https://www.readbyqxmd.com/read/28284324/readdressing-the-entity-of-exercise-pulmonary-arterial-hypertension
#7
REVIEW
Boris I Medarov, Sidharth Jogani, Johnathan Sun, Marc A Judson
Exercise pulmonary hypertension (EPH) indicates an abnormally elevated pulmonary artery pressure (PAP) during exercise. The physiological range of PAP during exercise remains poorly defined and, therefore, a universally accepted definition of EPH remains elusive. Nevertheless, previous data concerning the distribution of PAP in normal populations and more recent retrospective clinical data enhanced our ability to define EPH. EPH can impair exercise capacity and cause dyspnea. The underlying pathophysiology of the arterial form of EPH (EPAH) appears to be similar to that seen in resting pulmonary arterial hypertension (PAH), and EPAH individuals are at risk of developing resting PAH...
March 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28279499/tadalafil-in-idiopathic-or-heritable-pulmonary-arterial-hypertension-pah-compared-to-pah-associated-with-connective-tissue-disease
#8
Nazzareno Galiè, Christopher P Denton, Fabio Dardi, Alessandra Manes, Gaia Mazzanti, Baohui Li, Lucio Varanese, Anne Esler, Cathi Harmon, Massimiliano Palazzini
BACKGROUND: The primary objective of this post hoc analysis was to evaluate clinical outcomes of tadalafil in patients with pulmonary arterial hypertension (PAH) associated with connective tissue disease (CTD-PAH) compared with patients with idiopathic/heritable PAH (I/H-PAH) for primary and key secondary efficacy endpoints, and safety. This analysis included adult patients with CTD-PAH or I/H-PAH who participated in the PHIRST and PHIRST-2 studies. METHODS: Patients were randomized 1:1:1:1:1 to tadalafil (2...
February 22, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28275353/advances-in-the-evaluation-of-respiratory-pathophysiology-during-exercise-in-chronic-lung-diseases
#9
REVIEW
Denis E O'Donnell, Amany F Elbehairy, Danilo C Berton, Nicolle J Domnik, J Alberto Neder
Dyspnea and exercise limitation are among the most common symptoms experienced by patients with various chronic lung diseases and are linked to poor quality of life. Our understanding of the source and nature of perceived respiratory discomfort and exercise intolerance in chronic lung diseases has increased substantially in recent years. These new mechanistic insights are the primary focus of the current review. Cardiopulmonary exercise testing (CPET) provides a unique opportunity to objectively evaluate the ability of the respiratory system to respond to imposed incremental physiological stress...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28275174/physiological-and-clinical-relevance-of-exercise-ventilatory-efficiency-in-copd
#10
REVIEW
J Alberto Neder, Danilo C Berton, Flavio F Arbex, Maria Clara Alencar, Alcides Rocha, Priscila A Sperandio, Paolo Palange, Denis E O'Donnell
Exercise ventilation (V'E) relative to carbon dioxide output (V'CO2 ) is particularly relevant to patients limited by the respiratory system, e.g. those with chronic obstructive pulmonary disease (COPD). High V'E-V'CO2 (poor ventilatory efficiency) has been found to be a key physiological abnormality in symptomatic patients with largely preserved forced expiratory volume in 1 s (FEV1). Establishing an association between high V'E-V'CO2 and exertional dyspnoea in mild COPD provides evidence that exercise intolerance is not a mere consequence of detraining...
March 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28267959/survival-of-japanese-patients-with-idiopathic-heritable-pulmonary-arterial-hypertension
#11
Aiko Ogawa, Toru Satoh, Yuichi Tamura, Keiichi Fukuda, Hiromi Matsubara
Idiopathic/heritable pulmonary arterial hypertension has a poor prognosis despite the available therapeutic options. Survival of Japanese patients with this disease entity has not been reported in the multicenter setting. A retrospective study of 141 patients with idiopathic/heritable pulmonary arterial hypertension treated at 3 pulmonary hypertension centers in Japan from 1992 to 2012 investigated survival and determinants of survival. Mean survival time from treatment initiation was 14.7 ± 0.8 years (95% confidence interval, 13...
February 9, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28266825/cardiovascular-disease-update-pulmonary-hypertension
#12
Johnathan D McDivitt, Craig Barstow
Pulmonary hypertension (PH) is a spectrum disorder with multiple causes of the elevation of pressure in the lungs. It often is difficult to diagnose because it mimics many commonly reported symptoms (eg, dyspnea, exercise intolerance, chest pain). Diagnosis is made via right heart catheterization; however, transthoracic echocardiography may show evidence of elevated pulmonary pressure as the first clue to the diagnosis. Diagnostic tests to consider include a liver panel, complete blood count, and thyroid function test; electrocardiogram; chest x-ray; pulmonary function testing; and possibly lung imaging via computed tomography scan or ventilation-perfusion scan...
March 2017: FP Essentials
https://www.readbyqxmd.com/read/28256427/midterm-effect-of-balloon-pulmonary-angioplasty-on-hemodynamics-and-subclinical-myocardial-damage-in-chronic-thromboembolic-pulmonary-hypertension
#13
Mai Kimura, Takashi Kohno, Takashi Kawakami, Masaharu Kataoka, Toshimitsu Tsugu, Keitaro Akita, Sarasa Isobe, Yuji Itabashi, Yuichiro Maekawa, Mitsushige Murata, Keiichi Fukuda
BACKGROUND: The acute favourable effect of balloon pulmonary angioplasty (BPA) has been proven in patients with chronic thromboembolic pulmonary hypertension (CTEPH). However, data on its effect 6 months after therapy (from now on referred to as mid-term) and influence on the right ventricle and myocardial damage are sparse. To evaluate factors that influence improvement in cardiac output (CO) and subclinical myocardial damage, we examined hemodynamics and serum high-sensitivity troponin T (hs-TnT) levels before, 1 week after, and 6 months after BPA...
December 8, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28244596/cardiopulmonary-exercise-testing-improves-diagnostic-specificity-in-patients-with-echocardiography-suspected-pulmonary-hypertension
#14
Qin-Hua Zhao, Lan Wang, Bigyan Pudasaini, Rong Jiang, Ping Yuan, Su-Gang Gong, Jian Guo, Qiang Xiao, Hui Liu, Cheng Wu, Zhi-Cheng Jing, Jin-Ming Liu
BACKGROUND: Doppler echocardiography is usually the first diagnostic investigation for patients suspected with pulmonary hypertension (PH), but it is often inaccurate when used alone, especially in mild PH. HYPOTHESIS: Cardiopulmonary exercise testing (CPET) may serve as a complementary tool to improve diagnostic accuracy in echocardiography-suspected "PH possible" patients. METHODS: Eighty-eight consecutive patients with suspected PH (referred to as "PH possible" hereafter) based on echocardiography were included in the study...
February 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28239753/six-minute-walk-test-in-evaluation-of-children-with-pulmonary-arterial-hypertension
#15
Malgorzata Zuk, Anna Migdal, Dorota Jagiellowicz-Kowalska, Katarzyna Mazurkiewicz, Anna Sadel-Wieczorek, Grazyna Brzezinska-Rajszys
Six-minute walk test (6MWT) is a submaximal exercise test applied for evaluation of adults with pulmonary arterial hypertension (PAH). It was widely used as an endpoint in the clinical trials. The aim of the study was to assess the usefulness of 6MWT in management of children with PAH and to establish correlations with other clinical features. 164 6MWT were performed in 15 children between 5 and 18 years with PAH confirmed by right heart catheterization (102 in patients with shunt, 62 without shunt). Distance in 6MWT (6MWD)-% of predicted for age and gender, desaturation at the maximum effort, peak heart rate (HR)-% of maximal HR, were compared to the level of NTproBNP, WHO-FC, echocardiography parameters, and events of PAH treatment intensification...
February 27, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28214153/arrhythmogenic-right-ventricular-dysplasia-atypical-clinical-presentation
#16
José Marçalo, Luiz Menezes Falcão
A 67-year-old man was admitted to our hospital after episodes of syncope preceded by malaise and diffuse neck and chest discomfort. No family history of cardiac disease was reported. Laboratory workup was within normal limits, including D-dimers, serum troponin I and arterial blood gases. The electrocardiogram showed sinus rhythm with T-wave inversion in leads V1 to V3. Computed tomography angiography to investigate pulmonary embolism showed no abnormal findings. Transthoracic echocardiography (TTE) displayed massive enlargement of the right ventricle with intact interatrial septum and no pulmonary hypertension...
March 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28213592/the-evidence-of-benefits-of-exercise-training-in-interstitial-lung-disease-a-randomised-controlled-trial
#17
Leona M Dowman, Christine F McDonald, Catherine J Hill, Annemarie L Lee, Kathryn Barker, Claire Boote, Ian Glaspole, Nicole S L Goh, Anne M Southcott, Angela T Burge, Rebecca Gillies, Alicia Martin, Anne E Holland
BACKGROUND: Uncertainty exists regarding the clinical relevance of exercise training across the range of interstitial lung diseases (ILDs). OBJECTIVE: To establish the impact of exercise training in patients with ILDs of differing aetiology and severity. METHODS: 142 participants with ILD (61 idiopathic pulmonary fibrosis (IPF), 22 asbestosis, 23 connective tissue disease-related ILD (CTD-ILD) and 36 with other aetiologies) were randomised to either 8 weeks of supervised exercise training or usual care...
February 17, 2017: Thorax
https://www.readbyqxmd.com/read/28187374/the-strengths-and-weaknesses-of-non-invasive-parameters-obtained-by-echocardiography-and-cardiopulmonary-exercise-testing-in-comparison-with-the-hemodynamic-assessment-by-the-right-heart-catheterization-in-patients-with-pulmonary-hypertension
#18
Katarzyna Ptaszyńska-Kopczyńska, Anna Krentowska, Emilia Sawicka, Anna Skoneczny, Małgorzata Jasiewicz, Małgorzata Knapp, Włodzimierz J Musiał, Bożena Sobkowicz, Karol A Kamiński
PURPOSE: Pulmonary hypertension (PH) diagnosis requires invasive assessment by right heart catheterization (RHC), but screening and monitoring are performed using non-invasive methods: echocardiography and cardiopulmonary exercise testing (CPET). The aim of the study was to assess correlations between the parameters obtained in non-invasive testing and RHC in patients with PH of different etiologies. MATERIAL/METHODS: The study included 53 medical records of PH patients (32 women) aged 29-81 years...
June 14, 2016: Advances in Medical Sciences
https://www.readbyqxmd.com/read/28184260/perioperative-management-of-left-ventricular-diastolic-dysfunction-and-heart-failure-an-anesthesiologist-s-perspective
#19
REVIEW
Taeha Ryu, Seok-Young Song
Anesthesiologists frequently see asymptomatic patients with diastolic dysfunction or heart failure for various surgeries. These patients typically show normal systolic function but abnormal diastolic parameters in their preoperative echocardiographic evaluations. The symptoms that are sometimes seen are similar to those of chronic obstructive pulmonary disease. Patients with diastolic dysfunction, and even with diastolic heart failure, have the potential to develop a hypertensive crisis or pulmonary congestion...
February 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28183533/chronic-embolic-pulmonary-hypertension-caused-by-pulmonary-embolism-and-vascular-endothelial-growth-factor-inhibition
#20
Evandro M Neto-Neves, Mary B Brown, Maria V Zaretskaia, Samin Rezania, Adam G Goodwill, Brian P McCarthy, Scott A Persohn, Paul R Territo, Jeffrey A Kline
Our understanding of the pathophysiological basis of chronic thromboembolic pulmonary hypertension (CTEPH) will be accelerated by an animal model that replicates the phenotype of human CTEPH. Sprague-Dawley rats were administered a combination of a single dose each of plastic microspheres and vascular endothelial growth factor receptor antagonist in polystyrene microspheres (PE) + tyrosine kinase inhibitor SU5416 (SU) group. Shams received volume-matched saline; PE and SU groups received only microspheres or SU5416, respectively...
February 7, 2017: American Journal of Pathology
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