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Pulmonary hypertension , CTEPH

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https://www.readbyqxmd.com/read/29332912/impairment-of-iodine-123-metaiodobenzylguanidine-123i-mibg-uptake-in-patients-with-pulmonary-artery-hypertension
#1
Kenjuro Higo, Kayoko Kubota, Sunao Miyanaga, Masaaki Miyata, Masatoyo Nakajo, Megumi Jinguji, Mitsuru Ohishi
According to recent studies, lung uptake of iodine-123-metaiodobenzylguanidine (123I-MIBG) is impaired in many lung diseases and low lung uptake of 123I-MIBG suggests endothelial dysfunction of the pulmonary artery. 123I-MIBG scintigraphy in patients with pulmonary hypertension (PH) has not yet been clinically evaluated. We hypothesized that the lung uptake of 123I-MIBG is reduced in patients with PH and differs among PH subtypes. The purpose of the present study was to analyze the lung uptake of 123I-MIBG in patients with PH and compare it with the data obtained by echocardiography or right heart catheterization...
January 15, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29329761/n-terminal-pro-b-type-natriuretic-peptide-for-monitoring-after-balloon-pulmonary-angioplasty-for-chronic-thromboembolic-pulmonary-hypertension
#2
Steffen D Kriechbaum, Christoph B Wiedenroth, Jan Sebastian Wolter, Regula Hütz, Moritz Haas, Andreas Breithecker, Fritz C Roller, Till Keller, Stefan Guth, Andreas Rolf, Christian W Hamm, Eckhard Mayer, Christoph Liebetrau
BACKGROUND: Balloon pulmonary angioplasty (BPA) is an emerging interventional treatment option for chronic thromboembolic pulmonary hypertension (CTEPH). The non-invasive monitoring of CTEPH patients is a clinical challenge. In this study we examined changes in N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients undergoing BPA for inoperable CTEPH and related them to peri-procedural success. METHODS: In this study we analyzed a total of 51 consecutive patients who underwent BPA treatment and completed a 6-month follow-up (6-MFU) between March 2014 and March 2017...
December 8, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29321405/reversible-parkinsonism-and-multiple-cerebral-infarctions-after-pulmonary-endarterectomy-in-a-patient-with-antiphospholipid-syndrome
#3
Mitsumasa Okano, Kazuhiko Nakayama, Naoki Tamada, Yuto Shinkura, Ken-Ichi Yanaka, Hiroyuki Onishi, Hidekazu Tanaka, Toshiro Shinke, Hiroshi Tanaka, Yutaka Okita, Noriaki Emoto, Ken-Ichi Hirata
Antiphospholipid syndrome (APS) is a cause of chronic thromboembolic pulmonary hypertension (CTEPH) and it is associated with an increased risk of postoperative neurological complications. We experienced a case of reversible parkinsonism after pulmonary endarterectomy (PEA) and subsequent multiple cerebral infarctions under standard anticoagulation therapy in a patient with CTEPH associated with APS. Strict management using a combination of antiplatelet and anticoagulation therapy should be considered in patients with a high titer of triple antiphospholipid antibodies in the perioperative period...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29319041/successful-pulmonary-thromboendarterectomy-in-a-patient-with-sickle-cell-disease-and-associated-resolution-of-a-leg-ulcer
#4
Abhinav Agrawal, Rakesh Shah, Matthew D Bacchetta, Arunabh Talwar
Pulmonary hypertension (PH) is a relatively frequent and severe complication of sickle cell disease (SCD). PH associated with SCD is classified as Group 5 PH. The exact pathogenesis of PH in SCD in not known. There are also very limited treatment options available at this time for such patients with Group 5 PH. Patients with SCD are predisposed to a hypercoagulable state and thus can also suffer from chronic thromboembolism. These patients can have associated chronic thromboembolic pulmonary hypertension (CTEPH), thus being classified as Group 4 PH...
January 2018: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/29318791/impact-of-balloon-pulmonary-angioplasty-on-hemodynamics-and-clinical-outcomes-in-patients-with-chronic-thromboembolic-pulmonary-hypertension-the-initial-korean-experience
#5
Woochan Kwon, Jeong Hoon Yang, Taek Kyu Park, Sung A Chang, Dong Seop Jung, Young Seok Cho, Sung Mok Kim, Tae Jung Kim, Hye Yoon Park, Seung Hyuk Choi, Duk Kyung Kim
BACKGROUND: The treatment of choice for chronic thromboembolic pulmonary hypertension (CTEPH) is pulmonary endarterectomy (PEA). However, not all patients are eligible for PEA, and some patients experience recurrence of pulmonary hypertension even after PEA. METHODS: Patients who underwent balloon pulmonary angioplasty (BPA) between December 2015 and April 2017 were enrolled from the Samsung Medical Center CTEPH registry. Enrolled patients underwent right heart catheterization, echocardiography, and 6-minute walk distance (6MWD) at baseline, 4 and 24 weeks after their first BPA session...
January 22, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29290029/the-clinical-value-of-assessing-right-ventricular-diastolic-function-after-balloon-pulmonary-angioplasty-in-patients-with-chronic-thromboembolic-pulmonary-hypertension
#6
Hidenori Moriyama, Mitsushige Murata, Toshimitsu Tsugu, Takashi Kawakami, Masaharu Kataoka, Takahiro Hiraide, Mai Kimura, Sarasa Isobe, Jin Endo, Takashi Kohno, Yuji Itabashi, Keiichi Fukuda
Chronic thromboembolic pulmonary hypertension (CTEPH) has a poor prognosis because of the associated progressive right heart failure. Accurate evaluation of right ventricular (RV) function would thus be useful to predict prognosis. However, the significance of RV diastolic function remains unclear. We aimed to identify which echocardiographic measures are most accurate, and potentially useful, in assessing RV diastolic function in patients with CTEPH, and to study the effects of balloon pulmonary angioplasty (BPA) on them...
December 30, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29284512/quantifying-the-learning-curve-for-pulmonary-thromboendarterectomy
#7
Smita Sihag, Bao Le, Alison S Witkin, Josanna M Rodriguez-Lopez, Mauricio A Villavicencio, Gus J Vlahakes, Richard N Channick, Cameron D Wright
BACKGROUND: Pulmonary thromboendarterectomy (PTE) is an effective treatment for chronic thromboembolic pulmonary hypertension (CTEPH), but is a technically challenging operation for cardiothoracic surgeons. Starting a new program allows an opportunity to define a learning curve for PTE. METHODS: A retrospective case review was performed of 134 consecutive PTEs performed from 1998 to 2016 at a single institution. Outcomes were compared using either a two-tailed t-test for continuous variables or a chi-squared test for categorical variables according to experience of the program by terciles (T)...
December 28, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29282032/riociguat-in-patients-with-chronic-thromboembolic-pulmonary-hypertension-results-from-an-early-access-study
#8
Vallerie V McLaughlin, Pavel Jansa, Jens E Nielsen-Kudsk, Michael Halank, Gérald Simonneau, Ekkehard Grünig, Silvia Ulrich, Stephan Rosenkranz, Miguel A Gómez Sánchez, Tomás Pulido, Joanna Pepke-Zaba, Joan Albert Barberá, Marius M Hoeper, Jean-Luc Vachiéry, Irene Lang, Francine Carvalho, Christian Meier, Katharina Mueller, Sylvia Nikkho, Andrea M D'Armini
BACKGROUND: Following positive results from the Phase III CHEST-1 study in patients with inoperable or persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH), the Phase IIIb CTEPH early access study (EAS) was designed to assess the safety and tolerability of riociguat in real-world clinical practice, as well as to provide patients with early access to riociguat before launch. Riociguat is approved for the treatment of inoperable and persistent/recurrent CTEPH. METHODS: We performed an open-label, uncontrolled, single-arm, early access study in which 300 adult patients with inoperable or persistent/recurrent CTEPH received riociguat adjusted from 1 mg three times daily (tid) to a maximum of 2...
December 28, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29279530/deeper-s-wave-in-lead-v5-and-broader-extent-of-t-wave-inversions-in-the-precordial-leads-are-clinically-useful-electrocardiographic-parameters-for-predicting-pulmonary-hypertension
#9
Miyuki Miura, Satoshi Ikeda, Takeo Yoshida, Yuki Yamagata, Tomoo Nakata, Seiji Koga, Yuji Koide, Hiroaki Kawano, Koji Maemura
Electrocardiography (ECG) is used to screen for pulmonary hypertension (PH). However, it is unclear which parameters of ECG are the most useful for screening.ECG parameters related to right ventricular hypertrophy criteria were examined in 145 ECGs of subjects who were suspected to have PH and underwent right heart catheterization (RHC) (age 58.4 ± 17.5 years, 112 women, mean pulmonary arterial pressure [MPAP] 35.4 ± 13.3 mmHg). Based on the results of RHC, 108 subjects had PH (56 pulmonary arterial hypertension [PAH] and 52 chronic thromboembolic pulmonary hypertension [CTEPH])...
December 27, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29278545/treatment-effect-of-balloon-pulmonary-angioplasty-in-chronic-thromboembolic-pulmonary-hypertension-quantified-by-automatic-comparative-imaging-in-computed-tomography-pulmonary-angiography
#10
Zhiwei Zhai, Hideki Ota, Marius Staring, Jan Stolk, Koichiro Sugimura, Kei Takase, Berend C Stoel
OBJECTIVES: Balloon pulmonary angioplasty (BPA) in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) can have variable outcomes. To gain more insight into this variation, we designed a method for visualizing and quantifying changes in pulmonary perfusion by automatically comparing computed tomography (CT) pulmonary angiography before and after BPA treatment. We validated these quantifications of perfusion changes against hemodynamic changes measured with right-sided heart catheterization...
December 22, 2017: Investigative Radiology
https://www.readbyqxmd.com/read/29278287/balloon-pulmonary-angioplasty-is-effective-for-treating-peripheral-type-chronic-thromboembolic-pulmonary-hypertension-in-elderly-patients
#11
Yuki Yamagata, Satoshi Ikeda, Tomoo Nakata, Tsuyoshi Yonekura, Seiji Koga, Takahiro Muroya, Yuji Koide, Hiroaki Kawano, Koji Maemura
AIM: Balloon pulmonary angioplasty (BPA) has recently been established as an effective therapy for peripheral-type chronic thromboembolic pulmonary hypertension (CTEPH). However, the safety and effectiveness of BPA in elderly patients with CTEPH have not been clarified. METHODS: A total of 19 patients with CTEPH who underwent BPA were recruited. The patients were assigned to groups by age, <70 years (non-elderly; n = 11) and ≥70 years (elderly; n = 8). Hemodynamic parameters, right ventricular function and plasma N-terminal pro-brain natriuretic peptide were assessed before and after BPA, and complications arising after BPA were also evaluated...
December 26, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29202745/the-association-of-n-terminal-pro-brain-type-natriuretic-peptide-with-hemodynamics-and-functional-capacity-in-therapy-naive-precapillary-pulmonary-hypertension-results-from-a-cohort-study
#12
T M Berghaus, J Kutsch, C Faul, W von Scheidt, M Schwaiblmair
BACKGROUND: N-terminal pro-brain-type natriuretic peptide (NT-proBNP) is currently used as a surrogate marker for disease severity in pulmonary hypertension (PH). However, NT-proBNP tends to have a high variability and may insufficiently correlate with hemodynamics and exercise capacity. METHODS: To investigate the association of NT-proBNP with hemodynamics and cardio-pulmonary exercise testing (CPET) in 84 therapy-naive patients with precapillary PH. RESULTS: NT-proBNP levels were significantly correlated with hemodynamics and CPET parameters except for cardiac index, diffusion capacity, PaO2 at peak exercise, and peak minute ventilation...
December 4, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29167118/exercise-facilitates-early-recognition-of-cardiac-and-vascular-remodeling-in-chronic-thrombo-embolic-pulmonary-hypertension-in-a-novel-cteph-swine-model
#13
Kelly Stam, Richard W B van Duin, Andre Uitterdijk, Zongye Cai, Dirk J Duncker, Daphne Merkus
Chronic thrombo-embolic pulmonary hypertension (CTEPH) develops in 4% of patients after pulmonary embolism and is accompanied by an impaired exercise tolerance, which is ascribed to the increased right ventricular (RV) afterload and a ventilation/perfusion (V/Q) mismatch in the lungs. This study investigated changes in arterial PO2 and hemodynamics in response to graded treadmill exercise during development and progression of CTEPH in a swine model. Swine were chronically instrumented and received multiple pulmonary embolisms by (i) microsphere infusion (Spheres) over five weeks, (ii) endothelial dysfunction by administration of eNOS inhibitor L-Nω-Nitroarginine methyl ester (LNAME) during seven weeks, (iii) combined pulmonary embolisms and endothelial dysfunction (LNAME+Spheres), or (iv) served as sham-operated controls (Sham)...
November 22, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29161579/correlation-between-lung-perfusion-blood-volume-and-spect-images-in-patients-with-chronic-thromboembolic-pulmonary-hypertension-by-balloon-pulmonary-angioplasty
#14
Hirofumi Koike, Eijun Sueyoshi, Ichiro Sakamoto, Masataka Uetani, Tomoo Nakata, Kouji Maemura
OBJECTIVES: We evaluated the reperfusion by balloon pulmonary angioplasty (BPA) in lung PBV and SPECT images. METHODS: In total, 17 patients and 57 sessions were evaluated. Pre-BPA and post-BPA lung PBV and SPECT/CT images, based on both anatomical segments and physiologic regions (upper/middle/lower) were compared. RESULTS: BPA had a positive effect on most hypoperfused/unperfused segments/regions. There was generally a high rate of agreement between PBV measurements and SPECT/CT...
November 11, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/29159269/pulmonary-artery-dysfunction-in-chronic-thromboembolic-pulmonary-hypertension
#15
Hidetoshi Chibana, Nobuhiro Tahara, Naoki Itaya, Takashi Ishimatsu, Masahiro Sasaki, Motoki Sasaki, Takaharu Nakayoshi, Masanori Ohtsuka, Shinji Yokoyama, Ken-Ichiro Sasaki, Takafumi Ueno, Yoshihiro Fukumoto
Background: Unresolved thromboemboli in the pulmonary arteries (PA) is known to cause chronic thromboembolic pulmonary hypertension (CTEPH). However, it remains unknown if vascular dysfunction in pulmonary arteries exists in patients with CTEPH. Methods and results: We enrolled 7 female patients with CTEPH in this study, who have stable pulmonary hemodynamics after balloon pulmonary angioplasty (age; 73.6 ± 3.0 years old, mean right atrial pressure; 4.1 ± 0...
December 2017: IJC Heart & Vasculature
https://www.readbyqxmd.com/read/29157517/balloon-pulmonary-angioplasty-for-chronic-thromboembolic-pulmonary-hypertension
#16
REVIEW
Ehtisham Mahmud, Omid Behnamfar, Lawrence Ang, Mitul P Patel, David Poch, Nick H Kim
Chronic thromboembolic pulmonary hypertension (CTEPH) is associated with several risk factors but is most frequently seen as a rare consequence of an acute pulmonary embolism. Surgical pulmonary thromboendarterectomy (PTE) is potentially curative for CTEPH with the best outcomes seen for the treatment of primarily proximal, accessible lobar or segmental disease. For surgically inoperable patients, percutaneous balloon pulmonary angioplasty (BPA) is feasible and has good short- to mid-term efficacy outcomes...
January 2018: Interventional cardiology clinics
https://www.readbyqxmd.com/read/29143501/-the-place-of-balloon-pulmonary-angioplasty-in-the-management-of-chronic-thromboembolic-pulmonary-hypertension
#17
Aileen Kharat, Béatrice Duxbury, Anne-Lise Hachull, Stéphane Noble, Hélène Bouvaist, Paola M Soccal, Frédéric Lador
Chronic thromboembolic pulmonary hypertension (CTEPH) is uncommon. Its diagnosis should not be delayed as its prognosis is poor if not treated. In most cases, an acute pulmonary embolism is found in the medical history of the patient. Once suspected, a specific work-up should be performed in a pulmonary hypertension (PH) center. The ventilation/perfusion scan has a central role in this workup but the emergence of non invasive imaging technologies provides morphological and functional information which take part in the therapeutic decision making, such as operability...
November 15, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29143104/left-ventricular-end-diastolic-dimension-and-septal-e-are-predictors-of-cardiac-index-at-rest-while-tricuspid-annular-plane-systolic-excursion-is-a-predictor-of-peak-oxygen-uptake-in-patients-with-pulmonary-hypertension
#18
Yoshihisa Nakano, Naoki Okumura, Shiro Adachi, Shigetake Shimokata, Fumitaka Tajima, Yoshihiro Kamimura, Toyoaki Murohara, Takahisa Kondo
Little is known regarding a correlation of hemodynamics at rest or exercise capacity with echocardiographic parameters in patients with pulmonary hypertension (PH). To clarify these potential correlations, we performed transthoracic echocardiography, right heart catheterization, and cardiopulmonary exercise testing in 53 patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). Left ventricular end-diastolic dimension (LVDd), early diastolic velocity of the septal mitral annulus (septal e'), tricuspid regurgitation peak gradient (TRPG), and tricuspid annular plane systolic excursion (TAPSE) were significantly correlated with cardiac index (LVDd; r = 0...
November 15, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29122755/renin-angiotensin-system-regulates-pulmonary-arterial-smooth-muscle-cell-migration-in-chronic-thromboembolic-pulmonary-hypertension
#19
Yun Xia Zhang, Ji Feng Li, Yuan Hua Yang, Zhen Guo Zhai, Song Gu, Yan Liu, Ran Miao, Ping Ping Zhong, Ying Wang, Xiao Xi Huang, Chen Wang
Pulmonary arterial smooth muscle cell (PASMC) migration plays a key role in vascular remodeling which occurs during development of chronic thromboembolic pulmonary hypertension (CTEPH). Activation of the renin-angiotensin system (RAS) contributes to vascular remodeling observed in many diseases including idiopathic pulmonary arterial hypertension. However, the role of RAS imbalance in CTEPH has not been characterized. Here, we hypothesize that RAS imbalance regulates vascular remodeling by promoting PASMC migration in CTEPH...
November 9, 2017: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/29107511/red-blood-cells-distribution-width-as-a-potential-prognostic-biomarker-in-patients-with-pulmonary-arterial-hypertension-and-chronic-thromboembolic-pulmonary-hypertension
#20
Anna Smukowska-Gorynia, Iga Tomaszewska, Katarzyna Malaczynska-Rajpold, Justyna Marcinkowska, Anna Komosa, Magdalena Janus, Anna Olasinska-Wisniewska, Sylwia Slawek, Aleksander Araszkiewicz, Stanislaw Jankiewicz, Tatiana Mularek-Kubzdela
BACKGROUND: Red blood cells distribution width (RDW) predicts survival in cardiovascular diseases. Little is known about the variability of RDW level over time among patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). To our knowledge, RDW has never been analysed as a marker of response to specific treatment. MATERIALS AND METHODS: We retrospectively analysed 77 patients for: i) RDW measured during the last hospitalisation before death or during the last follow-up (RDWlast); ii) mean RDW from all hospitalisations during the entire follow-up of the patient (RDWmean); iii) maximum RDW of all hospitalisations of each patient (RDWmax)...
August 24, 2017: Heart, Lung & Circulation
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