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Pulmonary hypertension AND exercise

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https://www.readbyqxmd.com/read/29652543/cardioprotection-by-intermittent-hypoxia-conditioning-evidence-mechanisms-and-therapeutic-potential
#1
Robert T Mallet, Eugenia B Manukhina, Steven S Ruelas, James L Caffrey, H Fred Downey
The calibrated application of limited duration, cyclic, moderately intense hypoxia-reoxygenation increases cardiac resistance to ischemia-reperfusion stress. These intermittent hypoxic conditioning (IHC) programs consistently produce striking reductions in myocardial infarction and ventricular tachyarrhythmias following coronary artery occlusion and reperfusion, and in many cases, improved contractile function and coronary blood flow. These IHC protocols are fundamentally different from those used to simulate sleep apnea, a recognized cardiovascular risk factor...
April 13, 2018: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29650544/evaluation-and-management-of-right-sided-heart-failure-a-scientific-statement-from-the-american-heart-association
#2
REVIEW
Marvin A Konstam, Michael S Kiernan, Daniel Bernstein, Biykem Bozkurt, Miriam Jacob, Navin K Kapur, Robb D Kociol, Eldrin F Lewis, Mandeep R Mehra, Francis D Pagani, Amish N Raval, Carey Ward
BACKGROUND AND PURPOSE: The diverse causes of right-sided heart failure (RHF) include, among others, primary cardiomyopathies with right ventricular (RV) involvement, RV ischemia and infarction, volume loading caused by cardiac lesions associated with congenital heart disease and valvular pathologies, and pressure loading resulting from pulmonic stenosis or pulmonary hypertension from a variety of causes, including left-sided heart disease. Progressive RV dysfunction in these disease states is associated with increased morbidity and mortality...
April 12, 2018: Circulation
https://www.readbyqxmd.com/read/29629733/exercise-hemodynamics-for-the-diagnosis-of-diastolic-dysfunction-in-dyspneic-patients-with-systemic-sclerosis
#3
Anne Graham Cummiskey, Amit Segev, Michael Segel, Jonathan Buber, Victor Guetta, Israel M Barbash, Dan Elian, Elad Asher, Ori Vaturi, Paul Fefer
OBJECTIVES: To assess the added diagnostic value of using exercise hemodynamics during RHC in assessment of patients with symptomatic SSc. METHODS: We performed 22 RHCs in 17 SSc patients with dyspnea and/or pulmonary arterial hypertension (PAH). Exercise was performed in 15 RHCs using isotonic arm exercises while holding a 1 kg weight in each hand. Measurements of pulmonary arterial pressure (PAP), pulmonary arterial wedge pressure (PAWP), and cardiac output (CO) were taken at rest and during peak exercise...
April 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29615545/pulmonary-endarterectomy-for-patients-with-chronic-thromboembolic-disease
#4
Şehnaz Olgun Yıldızeli, Alper Kepez, Serpil Taş, Mehmed Yanartaş, Ali Fuad Durusoy, Atakan Erkılınç, Bülent Mutlu, Cihangir Kaymaz, Hasan Sunar, Bedrettin Yıldızeli
OBJECTIVE: Chronic thromboembolic disease (CTED) is characterized by persistent pulmonary thromboembolic occlusions without pulmonary hypertension. Early surgical treatment by performing pulmonary endarterectomy (PEA) may improve symptoms. The goal of the study was to review our experience and early outcome of PEA in patients with CTED. METHODS: Data were prospectively collected on all patients who underwent PEA between 2011 and 2015. Patients with CTED and a mean pulmonary artery pressure (mPAP) of <25 mm Hg were identified...
April 2018: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/29609511/extended-release-oral-treprostinil-in-the-management-of-pulmonary-arterial-hypertension-clinical-evidence-and-experience
#5
James C Coons, Taylor Miller
Treprostinil diolamine is the first oral prostacyclin approved for the treatment of pulmonary arterial hypertension (PAH) to improve exercise capacity. Clinical studies have demonstrated modest benefit as monotherapy, whereas no difference in exercise capacity was observed with combination therapy. However, these trials were limited by subtherapeutic dosing owing to intolerable adverse effects. Prostacyclin-related adverse effects, such as nausea, diarrhea, headache, flushing, and jaw pain, are prevalent. More recent pharmacokinetic and clinical studies illustrate the dose-response relationship and the importance of achieving clinically effective doses...
January 2018: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/29607269/mycophenolate-mofetil-in-a-lupus-patient-with-pulmonary-hypertension
#6
Kirthi Machireddy, Zin Myint, Eric Dein, Stephen C Mathai, Philip Seo, Uzma Haque, Rebecca Manno, Homa Timlin
Pulmonary hypertension (PH) is a life-threatening complication of several, different connective tissue diseases, including systemic lupus erythematous (SLE), systemic sclerosis, and rheumatoid arthritis. PH can present early in SLE. The severity does not correlate with other organ disease activity or with disease duration. It is still debatable whether immunosuppressive therapy is useful for PH related to SLE or autoimmune connective tissue disease, as there are no large clinical trials. However, several case reports have shown improvement with cyclophosphamide and prednisone with or without vasodilator therapy...
January 29, 2018: Curēus
https://www.readbyqxmd.com/read/29605901/right-ventricular-septomarginal-trabeculation-hypertrophy-is-associated-with-disease-severity-in-patients-with-pulmonary-arterial-hypertension
#7
Yang Dong, Jiayu Sun, Dan Yang, Juan He, Wei Cheng, Ke Wan, Hong Liu, Andreas Greiser, Xiaoyue Zhou, Yuchi Han, Yucheng Chen
To characterize the morphological change in the right ventricle (RV) of patients with pulmonary artery hypertension (PAH) and further explore the correlation between septomarginal trabeculation (SMT) and right ventricular (RV) function, myocardial fibrosis, and exercise capacity in patients with PAH. Sixty untreated PAH patients were prospectively included from May 2016 to April 2017. All patients underwent comprehensive clinical evaluation and cardiac magnetic resonance (CMR). The area and diameter of the basal segment of SMT, and the mass of SMT were measured on cine SSFP images...
March 31, 2018: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29605474/hemodynamic-mechanisms-of-exercise-induced-pulmonary-hypertension-in-patients-with-lymphangioleiomyomatosis-the-role-of-exercise-stress-echocardiography
#8
Andrea Sonaglioni, Massimo Baravelli, Roberto Cassandro, Olga Torre, Davide Elia, Claudio Anzà, Sergio Harari
BACKGROUND: The pathogenesis of pulmonary hypertension (PH) in lymphangioleiomyomatosis (LAM) has not yet been completely clarified. The aim of this study was to conduct a noninvasive evaluation of the main hemodynamic mechanisms of exercise-induced PH in patients with LAM, assessed using exercise stress echocardiography. METHODS: Fifteen patients with LAM (mean age, 47 ± 13 years; all women) without resting PH were enrolled in a prospective single-center study and compared with 15 healthy female control subjects (mean age, 45...
March 28, 2018: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/29600086/exercise-training-in-pulmonary-arterial-hypertension
#9
REVIEW
Laura Adelaide Dalla Vecchia, Maurizio Bussotti
Pulmonary arterial hypertension (PAH) is characterized by a continuous increase in pre-capillary pulmonary vascular resistance (PVR) with a progressive reduction of cardiac output (CO). Similar to what occurs in left heart failure (HF), this represents the initial phase of a syndrome characterized by the progressive development of dyspnea and fatigue with increasing deterioration of exercise tolerance. Although the therapies introduced in the last two decades have determined a significant improvement of the clinical conditions of PAH patients, they have a little impact on exercise capacity and prognosis...
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29584808/urocortin-2-improves-right-ventricular-function-and-attenuates-pulmonary-arterial-hypertension
#10
Rui Adão, Pedro Mendes-Ferreira, Diana Santos-Ribeiro, Carolina Maia-Rocha, Luís Pimentel, Cláudia Pinto, Eamon P Mulvaney, Helen M Reid, B Therese Kinsella, François Potus, Sandra Breuils-Bonnet, Miriam T Rademaker, Steeve Provencher, Sebastién Bonnet, Adelino Leite-Moreira, Carmen Brás-Silva
Aims: Pulmonary arterial hypertension (PAH) is a devastating disease and treatment options are limited. Urocortin-2 (Ucn-2) has shown promising therapeutic effects in experimental and clinical left ventricular heart failure (HF). Our aim was to analyze the expression of Ucn-2 in human and experimental PAH, and to investigate the effects of human Ucn-2 (hUcn-2) administration in rats with monocrotaline (MCT)-induced pulmonary hypertension (PH). Methods and Results: Tissue samples were collected from patients with and without PAH and from rats with MCT-induced PH; and hUcn-2 (5ug/kg, bi-daily, i...
March 23, 2018: Cardiovascular Research
https://www.readbyqxmd.com/read/29579597/physiological-insights-of-exercise-hyperventilation-in-arterial-and-chronic-thromboembolic-pulmonary-hypertension
#11
Stefania Farina, Noemi Bruno, Cecilia Agalbato, Mauro Contini, Roberto Cassandro, Davide Elia, Sergio Harari, Piergiuseppe Agostoni
BACKGROUND: Pulmonary hypertension (PH) patients show, during exercise, an excessive increase in ventilation (VE ) compared to carbon dioxide output (VCO2 ), determining a high VE /VCO2 slope. There are several possible causes, including an elevated dead space ventilation (VD ), VE /perfusion (Q) mismatch and/or an enhanced peripheral or central chemoreceptor activity. We evaluated the causes of exercise hyperventilation in PH patients. METHODS: Eighteen group I and IV PH patients underwent cardiopulmonary exercise test with blood gas analysis at every minute...
May 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29570476/patent-foramen-ovale-and-hypoxemia
#12
Mohammad K Mojadidi, Juan C Ruiz, Jason Chertoff, Muhammad O Zaman, Islam Y Elgendy, Ahmed N Mahmoud, Mohammad Al-Ani, Akram Y Elgendy, Nimesh K Patel, Ghanshyam Shantha, Jonathan M Tobis, Bernhard Meier
Patent foramen ovale (PFO), an embryonic remnant of the fetal circulation, is present in 20-25% of adults. While recent observational studies and clinical trials have established the link between PFO-mediated right-to-left shunting with cryptogenic stroke and migraine with aura, the role of a PFO in exacerbating hypoxemic medical conditions (i.e., sleep apnea, chronic obstructive pulmonary disease, pulmonary hypertension, platypnea-orthodeoxia, pulmonary arteriovenous malformation, high altitude pulmonary edema, and exercise desaturation) remains poorly evaluated...
March 22, 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29566672/characteristics-of-exercise-capacity-in-female-systemic-lupus-erythematosus-associated-pulmonary-arterial-hypertension-patients
#13
Bigyan Pudasaini, Guo-Ling Yang, Chen Yang, Jian Guo, Ping Yuan, Yang Wen-Lan, Rui Zhang, Lan Wang, Qin-Hua Zhao, Su-Gang Gong, Rong Jiang, Tian-Xiang Chen, Xiong Wei, Jin-Ming Liu
BACKGROUND: To study the oxygen uptake efficiency and determine usefulness of submaximal parameters of oxygen uptake in systemic lupus erythematosus associated pulmonary arterial hypertension (SLE PAH) on performing a cardiopulmonary exercise test (CPET). METHODS: CPET was performed in 21 SLE PAH patients, equal number of idiopathic pulmonary arterial hypertension (IPAH) patients and controls. Peak VO2 , anaerobic threshold (AT), oxygen uptake efficiency slope (OUES) and oxygen uptake efficiency plateau (OUEP) and other CPET parameters were examined...
March 23, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29564533/effect-of-6-min-walk-test-on-pro-bnp-levels-in-patients-with-pulmonary-arterial-hypertension
#14
Vikas Pathak, Robert Aris, Brian C Jensen, Wei Huang, Hubert James Ford
BACKGROUND: Plasma pro-BNP (brain natriuretic peptide) levels are often elevated in response to right ventricular (RV) volume and pressure overload, parameters potentially affected by exercise. Plasma pro-BNP levels change in association with long-term changes in pulmonary hemodynamics, thereby serving as a potential biomarker in pulmonary arterial hypertension (PAH). The 6-min Walk Test (6MWT) and pro-BNP level are often checked in a single office visit. There is no universal standard for measuring Pro-BNP levels relative to the timing of the 6MWT...
March 21, 2018: Lung
https://www.readbyqxmd.com/read/29552698/systolic-pulmonary-artery-pressure-assessed-during-routine-exercise-doppler-echocardiography-insights-of-a-real-world-setting-in-patients-with-elevated-pulmonary-pressures
#15
Susanne Korff, Patricia Enders-Gier, Lorenz Uhlmann, Matthias Aurich, Sebastian Greiner, Kristof Hirschberg, Hugo A Katus, Derliz Mereles
Pulmonary hypertension is a marker of disease severity. Exercise Doppler echocardiography (EDE) has proven to be feasible and reliable to assess pulmonary pressure. Increase in systolic pulmonary artery pressure (sPAP) has diagnostic and prognostic value in controlled studies. However, its value when assessed during routine examination in patients with cardiopulmonary diseases and resting sPAP > 35 mmHg is not clearly defined. Clinical documentation and offline reevaluation of digitally stored EDE examinations of patients with appropriate clinical indications for EDE were analyzed...
March 19, 2018: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29540357/pulmonary-arterial-hypertension-pathogenesis-and-clinical-management
#16
REVIEW
Thenappan Thenappan, Mark L Ormiston, John J Ryan, Stephen L Archer
Pulmonary hypertension is defined as a resting mean pulmonary artery pressure of 25 mm Hg or above. This review deals with pulmonary arterial hypertension (PAH), a type of pulmonary hypertension that primarily affects the pulmonary vasculature. In PAH, the pulmonary vasculature is dynamically obstructed by vasoconstriction, structurally obstructed by adverse vascular remodeling, and pathologically non-compliant as a result of vascular fibrosis and stiffening. Many cell types are abnormal in PAH, including vascular cells (endothelial cells, smooth muscle cells, and fibroblasts) and inflammatory cells...
March 14, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29535512/the-relationship-between-exercise-capacity-and-different-functional-markers-in-pulmonary-rehabilitation-for-copd
#17
Maria Kerti, Zsuzsanna Balogh, Krisztina Kelemen, Janos T Varga
Rationale: The relationship of functional parameters such as lung mechanics, chest kinematics, metabolism and peripheral and respiratory muscle function with the level of exercise tolerance remains a controversial subject. While it has been previously shown that pulmonary rehabilitation is capable of improving exercise tolerance in patients afflicted by COPD, as expressed by values of 6-minute walking test (6MWT), the degree of contribution to this change by each of the aforementioned parameters remains unclear...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29517668/the-efficiency-of-endothelin-receptor-antagonist-bosentan-for-pulmonary-arterial-hypertension-associated-with-congenital-heart-disease-a-systematic-review-and-meta-analysis
#18
REVIEW
Hong-Yu Kuang, Yu-Hao Wu, Qi-Jian Yi, Jie Tian, Chun Wu, We Nian Shou, Tie-Wei Lu
BACKGROUND: Oral bosentan has been widely applied in pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD). A systemic review and meta-analysis was conducted for a therapeutic evaluation of oral bosentan in both adult and pediatric patients with PAH-CHD. The acute responses and a long-term effect were respectively assessed in a comparison with baseline characteristics, and the improvement of exercise tolerance was analyzed. METHODS: PubMed, Medline, Embase, and Cochrane Central Register of clinical controlled trails or observational studies have been searched for a recording of bosentan effects on the PAH-CHD participants...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29490637/study-protocol-for-a-randomised-controlled-trial-of-exercise-training-in-pulmonary-hypertension-extra_ph
#19
Norman R Morris, Menaka Louis, Wendy Strugnell, Julie Harris, Aaron Lin, John Feenstra, Helen Seale
BACKGROUND: Exercise training is an integral component of evidence-based management programs for many chronic cardiac and respiratory conditions. Despite this, there are limited high-quality studies available on the significance of exercise training in pulmonary hypertension (PH). The aim of this study is to evaluate the short and long-term effectiveness of exercise training in PH patients in terms of exercise capacity, quality of life, cardiac function and disease progression. METHODS: This randomized control trial will aim to recruit 50 medically stable PH patients categorised as New York Heart Association functional classification II-III...
March 1, 2018: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29487995/treatment-of-atrial-fibrillation-in-patients-with-enhanced-sympathetic-tone-by-pulmonary-vein-isolation-or-pulmonary-vein-isolation-and-renal-artery-denervation-clinical-background-and-study-design-the-asaf-trial-ablation-of-sympathetic-atrial-fibrillation
#20
Mark R de Jong, Annemiek F Hoogerwaard, Ahmet Adiyaman, Jaap Jan J Smit, Anand R Ramdat Misier, Jan-Evert Heeg, Boudewijn A A M van Hasselt, Isabelle C Van Gelder, Harry J G M Crijns, Ignacio Fernández Lozano, Jorge E Toquero Ramos, F Javier Alzueta, Borja Ibañez, José M Rubio, Fernando Arribas, José M Porres Aracama, Josep Brugada, Lluís Mont, Arif Elvan
BACKGROUND: Hypertension is an important, modifiable risk factor for the development of atrial fibrillation (AF). Even after pulmonary vein isolation (PVI), 20-40% experience recurrent AF. Animal studies have shown that renal denervation (RDN) reduces AF inducibility. One clinical study with important limitations suggested that RDN additional to PVI could reduce recurrent AF. OBJECTIVE: The goal of this multicenter randomized controlled study is to investigate whether RDN added to PVI reduces AF recurrence...
February 27, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
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