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Pulmonary blood flow

Per Martin Arvidsson, Johannes Töger, Marcus Carlsson, Katarina Steding-Ehrenborg, Gianni Pedrizzetti, Einar Heiberg, Hakan Arheden
Intracardiac blood flow is driven by hemodynamic forces that are exchanged between the blood and myocardium. Previous studies have been limited to 2D measurements or investigated only LV forces. Right ventricular forces and their mechanistic contribution to asymmetric redirection of flow in the RV have not been measured. We therefore aimed to quantify three-dimensional hemodynamic forces in both ventricles in a cohort of healthy subjects, using magnetic resonance imaging 4D flow measurements. 25 controls,14 elite endurance athletes, and two patients with left ventricular dyssynchrony were included...
October 21, 2016: American Journal of Physiology. Heart and Circulatory Physiology
Anukul Ghimire, Mads Andersen, Lindsay M Burrowes, James Christopher Bouwmeester, Andrew D Grant, Israel Belenkie, Nowell M Fine, Barry A Borlaug, John V Tyberg
Using the reservoir-wave approach (RWA) we previously characterized pulmonary vasculature mechanics in a normal canine model. We found reflected backward-travelling waves that decrease pressure and increase flow in the proximal pulmonary artery (PA). These waves decrease right ventricular (RV) afterload and facilitate RV ejection. With pathological alterations to the pulmonary vasculature, these waves may change and impact RV performance. Our objective in this study was to characterize PA wave reflection and the alterations in RV performance in cardiac patients, using the RWA...
October 20, 2016: Journal of Applied Physiology
Umit Kervan, Sinan Sabit Kocabeyoglu, Dogan Emre Sert, Emre Aygün, Kemal Kavasoglu, Mehmet Karahan, Ertekin Utku Unal, Mustafa Pac
OBJECTIVES: The common femoral artery is the standard site for immediate vascular access when initiating adult venoarterial extracorporeal membrane oxygenation. However, this approach is fraught with problems such as femoral artery occlusion, distal limb ischemia, reperfusion injury resulting in compartment syndrome, retroperitoneal hemorrhage, thrombosis, embolization, and most importantly, pulmonary edema. Here, we show our preference of using the subclavian artery with a side graft as a different cannulation technique for outflow of extracorporeal membrane oxygenation, which can avoid complications associated with different access techniques...
October 14, 2016: Experimental and Clinical Transplantation
Matthias Peter Hilty, Andrea Müller, Daniela Flück, Christoph Siebenmann, Peter Rasmussen, Stefanie Keiser, Katja Auinger, Carsten Lundby, Marco Maggiorini
: Matthias Peter Hilty, Andrea Mueller, Daniela Flück, Christoph Siebenmann, Peter Rasmussen, Stefanie Keiser, Katja Auinger, Carsten Lundby, and Marco Maggiorini. Effect of increased blood flow on the pulmonary circulation before and during high altitude acclimatization. High Alt Med Biol. 00:000-000, 2016.-Introduction and Methods: Acute exposure to high altitude increases pulmonary artery pressure (Ppa) and pulmonary vascular resistance (PVR). The evolution of Ppa and PVR with continuous hypoxic exposure remains, however, elusive...
October 18, 2016: High Altitude Medicine & Biology
Cori R Atlin, Christoph Haller, Osami Honjo, Anusha Jegatheeswaran, Glen S Van Arsdell
BACKGROUND: Size mismatch between body and a systemic-to-pulmonary shunt can result in excessive pulmonary blood flow, compromising systemic oxygen delivery. Previously reported techniques to mechanically restrict shunt flow lack precision and reproducibility. We developed a formula for shunt banding and assessed its efficacy and reproducibility by in vitro and clinical measurements. METHODS: Formulas to determine diameter reduction, length of banding, and effect on the ratio of pulmonary blood flow (Qp) to systemic blood flow (Qs) were established...
November 2016: Journal of Thoracic and Cardiovascular Surgery
Jonathan D Rich, Igor Gosev, Chetan B Patel, Susan Joseph, Jason N Katz, Peter M Eckman, Sangjin Lee, Kartik Sundareswaran, Ahmet Kilic, Brian Bethea, Behzad Soleimani, Brian Lima, Nir Uriel, Michael Kiernan
BACKGROUND: Early right-sided heart failure (RHF) after left ventricular assist device (LVAD) implantation is associated with increased mortality, but little is known about patients who develop late RHF (LRHF). We evaluated the incidence, risk factors, and clinical impact of LRHF in patients supported by axial-flow LVADs. METHODS: Data were analyzed from 537 patients enrolled in the HeartMate II (HM II; Thoratec/St. Jude) destination therapy clinical trial. LRHF was defined as the development of clinical RHF accompanied by the need for inotropic support occurring more than 30 days after discharge from the index LVAD implant hospitalization...
August 20, 2016: Journal of Heart and Lung Transplantation
Abhishek Raval, Bhavesh Thakkar, Tarun Madan, Nilesh Oswal, Rajiv Garg, Rhshikesh Umalkar, Komal Shah, Bhumika Maheriya
OBJECTIVES: We aimed to study the feasibility and outcomes of ductal stenting in patients with duct-dependent pulmonary blood flow (PBF). METHODS: Duct-dependent hypoxic patients with confluent pulmonary artery (PA) branches were enrolled for ductal stenting and followed regularly. RESULTS: Sixty patients, with a median age of 12 (1-1095) days and weight of 2.8 (2.2-8.9) kg, were enrolled. Median right PA (RPA) and left PA (LPA) Z-scores were -1...
October 13, 2016: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Massimo Miniati
Pulmonary infarction occurs in nearly one-third of the patients with acute pulmonary embolism. Infarcts are still often mistaken for pneumonia or lung cancer because of the deeply rooted belief that they ought to be triangular in shape. In reality, the apical portion of an embolized region is spared from infarction thanks to sufficient collateral blood flow. Infarcts are always arranged peripherally along the surface of the visceral pleura (costal, diaphragmatic, mediastinal, or interlobar). Their free margin is sharp and convex toward the hilum, casting a semicircular or cushion-like density on chest radiography or computed tomography (CT)...
October 15, 2016: Seminars in Thrombosis and Hemostasis
Mohamed Ghalayini, Pierre-Yves Brun, Pascal Augustin, Elise Guivarch, Marie Pierre Dilly, Sophie Provenchere, Pierre Mordant, Yves Castier, Philippe Montravers, Dan Longrois
Competitive flows syndrome result in severe regional hypoxemia when the deoxygenated flow from the native left ventricle (LV) competes with oxygenated flow from extracorporeal life support (ECLS) pump with potentially severe consequences for the cerebral and coronary circulations. Fast correction of hypoxemia could be obtained by decreasing native LV flow by infusion of a short-acting beta-blocker (esmolol). Our purpose was to retrospectively review the efficacy of esmolol in this situation and hypothesize on the potential mechanisms of action and the associated risks...
September 2016: Journal of Extra-corporeal Technology
Rintaro Yokoyama, Satoshi Iihoshi, Kei Miyata, Kentaro Toyama, Katsuya Komatsu, Masahiko Wanibuchi, Nobuhiro Mikuni
OBJECT: We report a relatively rare case of pediatric iatrogenic extradural vertebral arteriovenous fistula. CASE: A five-year-old boy with a history of multiple surgeries for Total Anomalous Pulmonary Venous Return(TAPVR)exhibited vascular engorgement of his right neck from about 4 years old. We thought that this was caused by his past operations. He demonstrated swollen blood vessels in the right neck and pulmonary hypertension with increased right heart load...
October 2016: No Shinkei Geka. Neurological Surgery
Bharti Chogtu, Sanitha Kuriachan, Rahul Magazine, K Ranjan Shetty, Asha Kamath, Manu Mathew George, Amruta Tripathy, D Mahesh Kumar
OBJECTIVES: Statins by their anti-inflammatory and endothelial stabilizing effect can be beneficial in patients with chronic obstructive pulmonary disease (COPD) and pulmonary hypertension (PH). The present study was done to evaluate the effect of rosuvastatin on pulmonary functions and quality of life (QOL) in patients with concomitant COPD and PH. MATERIALS AND METHODS: It was a prospective, randomized, double-blind, placebo-controlled, study conducted in patients with COPD and PH...
September 2016: Indian Journal of Pharmacology
Rosalinda Madonna, Raffaele De Caterina, Yong-Jian Geng
Characterized by progressive elevation of mean pulmonary artery pressure and pulmonary vascular resistance, pulmonary arterial hypertension (PAH) is an important health problem that contributes to right heart failure. Pulmonary arterial remodeling and constriction are two prominent features of PAH. It is a traditional view that increasing pulmonary blood flow and pressure, aerobic exercise does more harm than good to the pulmonary vasculature in PAH. However, recent studies have documented a potential benefit of low-intensity aerobic exercise for PAH patients...
October 5, 2016: Vascular Pharmacology
Lourdes Dias, Mariana A P Rodrigues, André L Rennó, Alessandra Stroka, Bruna R Inoue, Patrícia C Panunto, Anibal R Melgarejo, Stephen Hyslop
In this work, we examined the hemodynamic responses to Lachesis muta (South American bushmaster) venom in anesthetized male Wistar rats. Venom (1.5 mg/kg, i.v.) caused immediate hypotension that was followed by a gradual return towards baseline over 60 min; there were no significant changes in heart rate, ECG parameters and respiratory rate. A higher dose (3 mg/kg, i.v.) caused sustained hypotension, variable bradycardia, respiratory depression and fluctuations in ECG; death occurred within 10-60 min. Venom injected intramuscularly (15 mg/kg) produced a smaller decrease in blood pressure that was more persistent than with 1...
October 5, 2016: Toxicon: Official Journal of the International Society on Toxinology
Mustafa Kemal Avsar, Tolga Demir, Cem Celiksular, Cenap Zeybek
BACKGROUND: PDA(Patent ductus arteriosus) is a common and clinically important condition which is presented with a number of hemodynamic and respiratory problems such as intraventricular hemorrhage, pulmonary hemorrhage and necrotizing enterocolitis due to increased pulmonary blood flow and stealing from systemic circulation. The incidence of PDA among the infants that were born before the 28th gestational week is as high as 70 %; and spontaneous closure rates in very-low-birth-weight premature neonates(VLBWPN) is around 34 %...
October 4, 2016: Journal of Cardiothoracic Surgery
Carla Frescura, Gaetano Thiene
Transposition of the great arteries (TGA) is a cardiac condition in which the arterial trunks arise from the inappropriate ventricle: the aorta from the right ventricle and the pulmonary trunk from the left ventricle [discordant ventriculo-arterial (VA) connection]. In complete TGA, the discordant VA connection is associated with situs solitus or inversus and concordant atrioventricular (AV) connection. The hemodynamic consequence of these combined connections is that systemic and pulmonary circulations function in "parallel" rather than in "series"...
2016: Frontiers in Pediatrics
Anders Andersson, Carina Malmhäll, Birgitta Houltz, Sara Tengvall, Margareta Sjöstrand, Ingemar Qvarfordt, Anders Lindén, Apostolos Bossios
BACKGROUND: Long-term exposure to tobacco smoke causes local inflammation in the airways that involves not only innate immune cells, including NK cells, but also adaptive immune cells such as cytotoxic (CD8(+)) and helper (CD4(+)) T-cells. We have previously demonstrated that long-term tobacco smoking increases extracellular concentration of the CD4(+)-recruiting cytokine interleukin (IL)-16 locally in the airways. Here, we hypothesized that tobacco smoking alters IL-16 biology at the systemic level and that this effect involves oxygen free radicals (OFR)...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Faith J Ross, Denise Joffe, Gregory J Latham
Total anomalous pulmonary venous connection (TAPVC) is a potentially devastating form of congenital heart disease in which all pulmonary blood flow returns to the systemic venous circulation rather than the left atrium. Anomalous pulmonary venous flow may be obstructed at birth, and affected infants present with severe cyanosis and poor cardiac output unresponsive to standard resuscitation with prostaglandin. Obstructed TAPVC remains one of the few indications for emergent neonatal cardiac surgery. This review will discuss the physiology and perioperative management of isolated TAPVC without associated cardiac lesions...
September 29, 2016: Seminars in Cardiothoracic and Vascular Anesthesia
Sharon L Cheatham, Grace M Deyo
Hybrid stage I palliation combines cardiothoracic surgery and interventional transcatheter procedures for treatment of hypoplastic left heart syndrome. The approach is an alternative to the Norwood procedure, the traditional first stage of surgical palliation. Hybrid stage I palliation involves placing bilateral branch pulmonary artery bands and a patent ductus arteriosus stent through a median sternotomy, performed without cardiopulmonary bypass. The purpose of the bands is to control blood flow to the lungs and protect the pulmonary bed while the stent sustains systemic cardiac output...
October 2016: Critical Care Nurse
Cemil Kavalci, Muhittin Serkan Yilmaz, Afsin Emre Kayipmaz, Bahattin Isık, Elif Celikel, Gulsum Kavalci, Fevzi Yilmaz, Miray Ozlem, Bedriye Muge Sonmez, Selman Celebi
INTRODUCTION: Chronic obstructive pulmonary disease (COPD) leads to physical activity limitation and a significant reduction in quality of life. This study aimed to investigate the correlation between The COPD Assessment Test (CAT) score and peak expiratory flow (PEF), and the factors effecting hospital admission rates of patients with COPD. METHODS: This observational study was conducted prospectively. CAT score was calculated and PEF measured at the time of emergency department admission...
2016: Journal of the National Medical Association
Esin Aktas Cetin, Leyla Pur Ozyigit, Yusuf Metin Gelmez, Erkan Cakir, Ahmet Hakan Gedik, Gunnur Deniz
OBJECTIVES: Childhood tuberculosis (TB) comprises an important part of the world's TB burden. Monocytes set up the early phase of infection because of innate immune responses. Understanding the changes in monocyte subsets during multisystem infectious diseases may be important for the development of novel diagnostic and therapeutic strategies. The aim of this study was to evaluate the monocyte phenotype together with the cytokine secretion profiles of children with pulmonary tuberculosis...
September 29, 2016: Pediatric Pulmonology
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