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Pulmonary hypertension , CTEPH

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https://www.readbyqxmd.com/read/27865192/effect-of-targeted-therapy-on-circulating-progenitor-cells-in-precapillary-pulmonary-hypertension
#1
Jéssica García-Lucio, Olga Tura-Ceide, Roberto Del Pozo, Isabel Blanco, Sandra Pizarro, Elisabet Ferrer, Marta Díez, Núria Coll-Bonfill, Lucilla Piccari, Víctor I Peinado, Joan Albert Barberà
BACKGROUND: Endothelial dysfunction is key in the development of pulmonary hypertension (PH) and is associated with reduced number of circulating progenitor cells. Studies to date evaluating levels of circulating progenitor cells in PH have provided conflicting results. Current treatment of pulmonary arterial hypertension (PAH) and medical treatment of chronic thromboembolic pulmonary hypertension (CTEPH) targets endothelium dependent signalling pathways. The effect of PAH-targeted therapy on circulating progenitor cells has not been clearly established...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27865180/detection-of-right-ventricular-myocardial-fibrosis-using-quantitative-ct-attenuation-of-the-right-ventricular-myocardium-in-the-late-phase-on-320-slice-ct-in-subjects-with-pulmonary-hypertension
#2
Koya Ozawa, Nobusada Funabashi, Hiroyuki Takaoka, Nobuhiro Tanabe, Koichiro Tatsumi, Yoshio Kobayashi
PURPOSE: Right ventricular myocardial (RVM) fibrosis may be a significant indicator of prognosis in pulmonary hypertension (PH). To detect the presence of RVM fibrosis in PH subjects, we employed ECG gated 320-slice CT. METHODS: 62 confirmed PH subjects (16 males; 55±16years; 45 chronic thromboembolic PH (CTEPH) who underwent conventional non-surgical medical therapy; and 17 pulmonary arterial hypertension (PAH)) underwent ECG-gated 320-slice CT. On CT, RV fibrosis was defined as contrast defect in the early phase and conversely abnormal enhancement in the late phase...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27852365/-the-study-of-growth-differentiation-factor-15-in-chronic-thromboembolic-pulmonary-hypertension-following-acute-pulmonary-thromboembolism
#3
J X Xu, H Z Yu, Q Wu, J Mi
Objective: To evaluate the incidence of chronic thromboembolic pulmonary hypertension (CTEPH) secondary to acute pulmonary thromboembolism (PTE) and the serum level of growth differentiation factor-15(GDF-15). Methods: Ninety-six acute PTE patients were recruited in the study. Clinical data, Wells score, blood gas analysis, D-dimmer level, GDF-15 level, atrial and ventricular sizes, pulmonary arterial systolic pressure (PASP) and pulmonary artery CT (CTPA) data were collected. Patients were followed up to evaluate the cardiac function (WHO class), ultrasonic cardiogram and CTPA to confirm the incidence of CTEPH...
November 12, 2016: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/27826972/risk-factors-detection-in-chronic-thromboembolic-pulmonary-hypertension-a-tool-for-risk-quantification
#4
M Bohacekova, M Kaldararova, T Valkovicova, A Remkova, J Vesely, I Simkova
BACKGROUND: Chronic thromboembolic pulmonary hypertension (CTEPH) is characterized by chronic thromboembolic obstruction in the pulmonary bed. The definitive pathogenesis remains incompletely explained, although multiple risk factors of CTEPH have been identified. The purpose of the study was to evaluate the risk profile of patients with CTEPH and the representativeness of risk factors, identify possible new CTEPH risk factors and specify the epidemiology of CTEPH in our country. METHODS: In 81 patients with CTEPH, well known risk factors were analyzed, and a detailed analysis of selected hematological parameters was investigated at a specialized hematology laboratory...
2016: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/27817818/clinical-usefulness-of-end-tidal-co2-profiles-during-incremental-exercise-in-patients-with-chronic-thromboembolic-pulmonary-hypertension
#5
R P Ramos, E V M Ferreira, F M Valois, A Cepeda, C M S Messina, R K Oliveira, A T V Araújo, C A Teles, J A Neder, L E Nery, J S Ota-Arakaki
INTRODUCTION: Great ventilation to carbon dioxide output (ΔV˙E/ΔV˙CO2) and reduced end-tidal partial pressures for CO2 (PetCO2) during incremental exercise are hallmarks of chronic thromboembolic pulmonary hypertension (CTEPH) and idiopathic pulmonary arterial hypertension (IPAH). However, CTEPH is more likely to involve proximal arteries, which may lead to poorer right ventricle-pulmonary vascular coupling and worse gas exchange abnormalities. Therefore, abnormal PetCO2 profiles during exercise may be more prominent in patients with CTEPH and could be helpful to indicate disease severity...
November 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27802345/circulating-angiopoietin-1-is-not-a-biomarker-of-disease-severity-or-prognosis-in-pulmonary-hypertension
#6
Manuel Jonas Richter, Svenja Lena Tiede, Natascha Sommer, Thomas Schmidt, Werner Seeger, Hossein Ardeschir Ghofrani, Ralph Schermuly, Henning Gall
BACKGROUND: Circulating angiopoietin-1 (Ang-1) has been linked to pulmonary hypertension (PH) in experimental studies. However, the clinical relevance of Ang-1 as a biomarker in PH remains unknown. We aimed to investigate the prognostic and clinical significance of Ang-1 in PH using data from the prospectively recruiting Giessen PH Registry. METHODS: Patients with suspected PH (without previous specific pulmonary arterial hypertension [PAH] therapy) who underwent initial right heart catheterization (RHC) in our national referral center between July 2003 and May 2012 and who agreed to optional biomarker analysis were included if they were diagnosed with idiopathic PAH, connective tissue disease-associated PAH (CTD-PAH), PH due to left heart disease (PH-LHD), or chronic thromboembolic PH (CTEPH), or if PH was excluded by RHC (non-PH controls)...
2016: PloS One
https://www.readbyqxmd.com/read/27801422/-clinical-guidelines-for-the-diagnosis-and-treatment-of-chronic-thromboembolic-pulmonary-hypertension-part-2
#7
I E Chazova, T V Martynyuk
The paper gives current approaches to treating chronic thromboembolic pulmonary hypertension (CTEPH) from the document «Federal Guidelines for the Diagnosis and Treatment of CTEPH» approved at the Third Russian Congress on Pulmonary Hypertension on December 11, 2015. The guidelines had been elaborated to optimize the treatment of patients with CTEPH on the basis of an analysis of the data of the present-day registries and multicenter randomized clinical trials, national and international guidelines and consensus documents, and documents published in recent years...
2016: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/27784118/c-arm-computed-tomography-adds-diagnostic-information-in-patients-with-chronic-thromboembolic-pulmonary-hypertension-and-a-positive-v-q-spect
#8
J B Hinrichs, T Werncke, T Kaireit, M M Hoeper, K M Olsson, J C Kamp, F K Wacker, F Bengel, C von Falck, I Schatka, B C Meyer
Purpose: To determine if C-Arm computed tomography (CACT) has added diagnostic value in patients suffering from chronic thromboembolic pulmonary hypertension (CTEPH) with a positive mismatch pattern in ventilation/perfusion single photon emission computed tomography (V/Q SPECT). Materials and Methods: 28 patients (23 men, 5 women, 62 ± 18 years) with CTEPH who had undergone SPECT, followed by CACT and right heart catheterization (RHC) were included. Two independent readers reviewed SPECT and CACT. Findings indicating CTEPH and their location (segmental or sub-segmental) were identified (V/Q mismatch in SPECT and vascular pathologies in CACT)...
October 26, 2016: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/27783357/three-dimensional-phase-contrast-magnetic-resonance-imaging-validated-to-assess-pulmonary-artery-flow-in-patients-with-chronic-thromboembolic-pulmonary-hypertension
#9
Masateru Kawakubo, Hiroshi Akamine, Yuzo Yamasaki, Atsushi Takemura, Kohtaro Abe, Kazuya Hosokawa, Junji Morishita, Michinobu Nagao
In this study, three-dimensional phase contrast magnetic resonance imaging (3D-PC MRI), a novel technique, was validated to assess pulmonary artery (PA) flow in patients with chronic thromboembolic pulmonary hypertension (CTEPH). The MR data of PAs from 3D-PC and two-dimensional PC (2D-PC) from before and after treatment for 3 patients with CTEPH were retrospectively analyzed. Additionally, 3D- and 2D-PC MR scans of PA were performed in 5 healthy volunteers. Correlation of stroke volumes (SVs) obtained by 3D-PC and 2D-PC was analyzed using Pearson's correlation coefficients...
October 25, 2016: Radiological Physics and Technology
https://www.readbyqxmd.com/read/27783213/a-prospective-randomized-study-of-inhaled-prostacyclin-versus-nitric-oxide-in-patients-with-residual-pulmonary-hypertension-after-pulmonary-endarterectomy
#10
Shinichiro Abe, Keiichi Ishida, Masahisa Masuda, Hideki Ueda, Hiroki Kohno, Kaoru Matsuura, Yusaku Tamura, Michiko Watanabe, Goro Matsumiya
OBJECTIVES: Pulmonary endarterectomy (PEA) is an effective treatment for chronic thromboembolic pulmonary hypertension (CTEPH), but postoperative residual hypertension leads to in-hospital mortality. Inhaled epoprostenol sodium (PGI2) and NO are administered for pulmonary hypertension after cardiothoracic surgery. This prospective study provides the first comparative evaluation of the effects of inhaled PGI2 and NO on pulmonary hemodynamics, systemic hemodynamics, and gas exchange in patients developing residual pulmonary hypertension after PEA...
October 25, 2016: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27760452/-chronic-thromboembolic-pulmonary-hypertension-recommendations-of-the-cologne-consensus-conference-2016
#11
H Wilkens, S Konstantinides, I Lang, A C Bunck, M Gerges, F Gerhardt, A Grgic, C Grohé, S Guth, M Held, J Hinrichs, M M Hoeper, W Klepetko, T Kramm, U Krüger, M Lankeit, B C Meyer, K M Olsson, H-J Schäfers, M Schmidt, H J Seyfarth, S Ulrich, C B Wiedenroth, E Mayer
The 2015 European Guidelines on Pulmonary Hypertension did not cover only pulmonary arterial hypertension (PAH), but also other significant subgroups of pulmonary hypertension (PH). In June 2016, a Consensus Conference organized by the PH working groups of the German Society of Cardiology (DGK), the German Society of Respiratory Medicine (DGP) and the German Society of Pediatric Cardiology (DGPK) was held in Cologne, Germany to discuss open and controversial issues surrounding the practical implementation of the European Guidelines...
October 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27750459/riociguat-for-the-treatment-of-pulmonary-hypertension-a-safety-evaluation
#12
Christina Binder, Caroline Zotter-Tufaro, Diana Bonderman
The development of pulmonary hypertension (PH) has multifactorial underlying pathophysiological causes and can be classified into five groups. While three different classes of therapeutic drugs are licensed for the treatment of pulmonary arterial hypertension (PAH, WHO group 1), specific medical therapies are lacking for other forms of PH, such as PH due to left heart disease. In 2013 riociguat, a first-in class soluble guanylate cyclase stimulator, has also become available for the treatment of PAH. Riociguat was further introduced as the first approved pharmacotherapy for the treatment of patients with chronic thromboembolic PH (WHO group 4, CTEPH)...
November 9, 2016: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/27746200/effect-of-balloon-pulmonary-angioplasty-on-respiratory-function-in-patients-with-chronic-thromboembolic-pulmonary-hypertension
#13
Mina Akizuki, Naoki Serizawa, Atsuko Ueno, Taku Adachi, Nobuhisa Hagiwara
RATIONALE: Balloon pulmonary angioplasty (BPA) in chronic thromboembolic pulmonary hypertension (CTEPH) improves hemodynamics and exercise capacity. However, its effect on respiratory function is unclear. OBJECTIVES: To investigate the effect of BPA on respiratory function. METHODS: We enrolled inoperable CTEPH who underwent BPA primarily in lower lobe arteries (first series) and upper and middle lobe arteries (second series). We compared changes in hemodynamics and respiratory function between different BPA fields...
October 13, 2016: Chest
https://www.readbyqxmd.com/read/27735920/-clinical-guidelines-for-the-diagnosis-and-treatment-of-chronic-thromboembolic-pulmonary-hypertension-part-1
#14
I E Chazova, T V Martynyuk
Chronic thromboembolic pulmonary hypertension (CTEPH) is precapillary pulmonary hypertension, in which chronic obstruction of large and middle branches of pulmonary arteries (PAs) and secondary changes in the lung microcirculatory bed result in a progressive increase in pulmonary vascular resistance and PA pressure with the development of severe right cardiac dysfunction and heart failure. CTEPH is a unique form of pulmonary hypertension since it is potentially curable by surgical treatment. The diagnostic criteria for CTEPH are a mean PA pressure of ≥25 mm Hg, as evidenced by right heart catheterization; a PA wedge pressure of ≤15 mm Hg; a pulmonary vascular resistance of >2 Wood units; the presence of chronic/organized thrombi/emboli in the elastic PAs (pulmonary trunk, lobular, segmental, subsegmental PAs); effective anticoagulant therapy at therapeutic dosages over at least 3 months...
2016: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/27733022/long-term-outcomes-of-surgery-for-chronic-thromboembolic-pulmonary-hypertension-compared-with-medical-therapy-at-a-single-korean-center
#15
Soo Han Kim, Jae Won Lee, Jung-Min Ahn, Dae-Hee Kim, Jong-Min Song, Sang-Do Lee, Jae Seung Lee
Background/Aims: Pulmonary endarterectomy (PEA) is the gold standard for treating chronic thromboembolic pulmonary hypertension (CTEPH) in Western countries. The aim of this study was to investigate the long-term outcomes of performing PEA on CTEPH patients in comparison with medical therapy at a single Korean center. Methods: This retrospective study included 88 CTEPH patients. These patients were classified into the PEA group (n = 37) or non-PEA group (i.e., medical therapy; n = 51)...
October 13, 2016: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/27683616/chronic-thromboembolic-pulmonary-hypertension-pregnancy-and-a-pulmonary-endarterectomy-a-rare-challenge
#16
Erika B Rosenzweig, Mauer Biscotti, Kirsten Cleary, Richard Smiley, Matthew D Bacchetta
It is well described that patients with group 1 forms of pulmonary arterial hypertension have a high risk of mortality during pregnancy and in the early postpartum period. However, to the authors' knowledge, the diagnosis and management of group 4 pulmonary hypertension due to chronic thromboembolic pulmonary hypertension (CTEPH) during pregnancy with early postpartum pulmonary endarterectomy (PEA) has not been previously reported. We report the case of a 28-year-old woman who received a diagnosis of CTEPH during her pregnancy, was managed as an inpatient by a multidisciplinary team throughout the pregnancy and early postpartum period, and underwent PEA 6 weeks after delivery...
September 2016: Pulmonary Circulation
https://www.readbyqxmd.com/read/27672065/balloon-pulmonary-angioplasty-improves-interventricular-dyssynchrony-in-patients-with-inoperable-chronic-thromboembolic-pulmonary-hypertension-a-cardiac-mr-imaging-study
#17
Yuzo Yamasaki, Michinobu Nagao, Kohtaro Abe, Kazuya Hosokawa, Satoshi Kawanami, Takeshi Kamitani, Torahiko Yamanouchi, Koshin Horimoto, Hidetake Yabuuchi, Hiroshi Honda
To use cardiac magnetic resonance imaging (MRI) to investigate the effect of balloon pulmonary angioplasty (BPA) on interventricular dyssynchrony and its associations with ventricular interaction, which impairs LV function in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH). This prospective observational study was approved by our institutional review board. Cardiac MRI and right heart catheterization were conducted before BPA sessions and at the follow up after BPA in 20 patients with CTEPH...
September 26, 2016: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/27651142/native-t1-mapping-and-extracellular-volume-fraction-measurement-for-assessment-of-right-ventricular-insertion-point-and-septal-fibrosis-in-chronic-thromboembolic-pulmonary-hypertension
#18
Fritz C Roller, Christoph Wiedenroth, Andreas Breithecker, Christoph Liebetrau, Eckhard Mayer, Christian Schneider, Andreas Rolf, Christian Hamm, Gabriele A Krombach
OBJECTIVES: The aim of this study was to assess septal and right ventricular insertion point (RVIP) fibrosis in patients with chronic thromboembolic pulmonary hypertension (CTEPH) via native T1 mapping and extracellular volume fraction (ECV) determination and to analyze correlations with functional parameters. METHODS: Imaging was performed at 1.5 Tesla in 24 patients diagnosed with CTEPH and 24 controls. T1 values were measured within the septal myocardium, the upper and lower RVIP, and the lateral wall at basal short axis section...
September 20, 2016: European Radiology
https://www.readbyqxmd.com/read/27614712/prognostic-and-pathophysiological-marker-for-patients-with-chronic-thromboembolic-pulmonary-hypertension-usefulness-of-diffusing-capacity-for-carbon-monoxide-at-diagnosis
#19
Rika Suda, Nobuhiro Tanabe, Keiichi Ishida, Fumiaki Kato, Takashi Urushibara, Ayumi Sekine, Rintaro Nishimura, Takayuki Jujo, Toshihiko Sugiura, Ayako Shigeta, Seiichiro Sakao, Koichiro Tatsumi
BACKGROUND AND OBJECTIVE: Chronic thromboembolic pulmonary hypertension (CTEPH) is a progressive disease in some patients, despite improved treatments. Microvasculopathy has been implicated in the poor outcomes of patients with CTEPH. A reduction in the diffusing capacity for carbon monoxide (DLCO ) was previously suggested to indicate microvasculopathy in CTEPH patients; therefore, we assessed DLCO /alveolar ventilation (DLCO /VA ) as a prognostic and pathophysiological marker in CTEPH...
September 11, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/27600256/tricuspid-annular-plane-systolic-excursion-in-chronic-thromboembolic-pulmonary-hypertension-before-and-after-pulmonary-thromboendarterectomy
#20
Darrin J Wong, Unnati Sampat, Michael A Gibson, William R Auger, Michael M Madani, Lori B Daniels, Ajit B Raisinghani, Anthony N DeMaria, Daniel G Blanchard
BACKGROUND: Right ventricular function is impaired in chronic thromboembolic pulmonary hypertension (CTEPH). Tricuspid annular plane systolic excursion (TAPSE) and right ventricular fractional area change (RVFAC) have been shown to help assess right ventricular function in pulmonary hypertension. Our goal was to (1) assess TAPSE and RVFAC before and after PTE, and (2) assess correlation of these variables with right heart catheterization data and PVR. METHODS: We evaluated 67 consecutive patients with CTEPH for pulmonary thromboendarterectomy (PTE)...
September 7, 2016: Echocardiography
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