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https://www.readbyqxmd.com/read/29158679/treatment-of-pulmonary-hypertension-with-left-heart-disease-a-concise-review
#1
REVIEW
Anish Desai, Shilpa A Desouza
Pulmonary hypertension (PH) is defined by a mean pulmonary artery pressure ≥ 25 mmHg, as determined by right heart catheterization. Pulmonary arterial hypertension (PAH) can no longer be considered an orphan disease given the increase in awareness and availability of new drugs. PH carries with it a dismal prognosis and leads to significant morbidity and mortality. Symptoms can range from dyspnea, fatigue and chest pain to right ventricular failure and death. PH is divided into five groups by the World Health Organization (WHO), based on etiology...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29154426/microvascular-dysfunction-and-cardiac-fibrosis-in-heart-failure-with-preserved-ejection-fraction-a-case-report
#2
Nikhil Narang, Diego Medvedofsky, Kathryn Dryer, Sanjiv J Shah, Charles J Davidson, Amit R Patel, John E A Blair
We report the case of a 55-year-old woman with heart failure with preserved ejection fraction (HFpEF), who presented with hypertensive urgency and pulmonary oedema. The patient was medically optimized and underwent cardiac catheterization revealing pulmonary hypertension, elevated pulmonary capillary wedge pressure, normal cardiac index, and non-obstructive coronary disease. Invasive evaluation of coronary flow revealed blunted coronary flow reserve and increased index of microvascular resistance. Cardiac magnetic resonance imaging demonstrated reduced global myocardial perfusion and diffuse interstitial fibrosis...
November 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29148140/haemodynamic-effects-of-an-acute-vasodilator-challenge-in-heart-failure-patients-with-reduced-ejection-fraction-and-different-forms-of-post-capillary-pulmonary-hypertension
#3
Stefano Ghio, Gabriele Crimi, Pier Luigi Temporelli, Egidio Traversi, Maria Teresa La Rovere, Antonia Cannito, Dario Vizza, Laura Scelsi, Claudia Raineri, Marco Guazzi, Luigi Oltrona Visconti
AIMS: The most recent European guidelines have proposed new definitions of pulmonary hypertension (PH) in left heart disease, to better approach the characteristics required to reflect the presence of pulmonary vascular disease. The purpose of this study was to assess whether different haemodynamic definitions of post-capillary PH imply a different reversibility of PH in response to acute vasodilator administration in heart failure patients with reduced ejection fraction and PH (HFrEF-PH)...
November 16, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29145950/a-combination-of-allogeneic-stem-cells-promotes-cardiac-regeneration
#4
Makoto Natsumeda, Victoria Florea, Angela C Rieger, Bryon A Tompkins, Monisha N Banerjee, Samuel Golpanian, Julia Fritsch, Ana Marie Landin, Nilesh D Kashikar, Vasileios Karantalis, Viky Y Loescher, Kostas E Hatzistergos, Luiza Bagno, Cristina Sanina, Muzammil Mushtaq, Jose Rodriguez, Marcos Rosado, Ariel Wolf, Kevin Collon, Louis Vincent, Anthony J Kanelidis, Ivonne H Schulman, Raul Mitrani, Alan W Heldman, Wayne Balkan, Joshua M Hare
BACKGROUND: The combination of autologous mesenchymal stem cells (MSCs) and cardiac stem cells (CSCs) synergistically reduces scar size and improves cardiac function in ischemic cardiomyopathy. Whereas allogeneic (allo-)MSCs are immunoevasive, the capacity of CSCs to similarly elude the immune system remains controversial, potentially limiting the success of allogeneic cell combination therapy (ACCT). OBJECTIVES: This study sought to test the hypothesis that ACCT synergistically promotes cardiac regeneration without provoking immunologic reactions...
November 14, 2017: Journal of the American College of Cardiology
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
#5
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/29142816/unilateral-pulmonary-edema-in-a-patient-with-worsening-tricuspid-valve-regurgitation-a-secret-inside-pulmonary-veins
#6
Elvira Resciniti, Ilaria Caso, Iside Scarfò, Giuseppe Di Pasquale, Giovanni La Canna
We present the case of a 69-year-old patient who was referred to the Department of Echocardiography for surgical treatment of severe tricuspid valve regurgitation (TVR) with advanced congestive heart failure. In 2013 the patient underwent unsuccessful percutaneous ablation for permanent atrial fibrillation. In 2015, following numerous episodes of atrial fibrillation and congestive heart failure with left pleural effusion, the patient was admitted to another center. A transthoracic echocardiogram showed severe TVR and moderate precapillary pulmonary hypertension, confirmed at right cardiac catheterization...
October 2017: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/29140312/plasma-amino-acid-abnormalities-in-chronic-heart-failure-mechanisms-potential-risks-and-targets-in-human-myocardium-metabolism
#7
Roberto Aquilani, Maria Teresa La Rovere, Daniela Corbellini, Evasio Pasini, Manuela Verri, Annalisa Barbieri, Anna Maria Condino, Federica Boschi
The goal of this study was to measure arterial amino acid levels in patients with chronic heart failure (CHF), and relate them to left ventricular function and disease severity. Amino acids (AAs) play a crucial role for heart protein-energy metabolism. In heart failure, arterial AAs, which are the major determinant of AA uptake by the myocardium, are rarely measured. Forty-one subjects with clinically stable CHF (New York Heart Association (NYHA) class II to IV) were analyzed. After overnight fasting, blood samples from the radial artery were taken to measure AA concentrations...
November 15, 2017: Nutrients
https://www.readbyqxmd.com/read/29132539/the-diabetic-heart-utilizes-ketone-bodies-as-an-energy-source
#8
Yuji Mizuno, Eisaku Harada, Hitoshi Nakagawa, Yoshinobu Morikawa, Makoto Shono, Fumihito Kugimiya, Michihiro Yoshimura, Hirofumi Yasue
BACKGROUND: Diabetic heart is characterized by failure of insulin to increase glucose uptake and increasingly relies on free fatty acids (FFAs) as a source of fuel in animal models. However, it is not well known how cardiac energy metabolism is altered in diabetic hearts in humans. We examined cardiac fuel metabolism in the diabetics as compared to non-diabetics who underwent cardiac catheterization for heart diseases. MATERIAL AND METHODS: The study subjects comprised 81 patients (male 55, female 26, average age 63...
December 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/29126717/2013-acr-eular-systemic-sclerosis-classification-criteria-in-patients-with-associated-pulmonary-arterial-hypertension
#9
Beatriz E Joven, Pilar Escribano, Jose Luis Andreu, Estibaliz Loza, Carmen Jimenez, M Jesus Garcia de Yebenes, M Jose Ruiz-Cano, Loreto Carmona, Patricia E Carreira
OBJECTIVE: To analyze the performance of the 1980 ACR and new 2013 ACR/EULAR criteria for systemic sclerosis (SSc) in cutaneous SSc (lcSSc) patients, especially those affected by lcSSc and pulmonary arterial hypertension (PAH). METHODS: All patients with a clinical lcSSc diagnosis from a prospective observational SSc cohort were included. Sociodemographic and disease-related variables were collected, and PAH confirmed by right heart catheterization (RHC). Performance of the 2013 and 1980 SSc criteria was analyzed in terms of clinical diagnosis...
October 13, 2017: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/29122104/the-diagnosis-of-chronic-coronary-heart-disease
#10
Christian Albus, Jörg Barkhausen, Eckart Fleck, Jörg Haasenritter, Oliver Lindner, Sigmund Silber
BACKGROUND: Chronic coronary heart disease (CHD) and acute myocardial infarction are endemic conditions. In Germany, an estimated 900 000 cardiac catheterizations were performed in the year 2014, and a percutaneous intervention was carried out in 40% of these procedures. It would be desirable to lessen the number of invasive diagnostic procedures while preserving the reliability of diagnosis. In this article, we present the updated recommendations of the German National Care Guideline for Chronic CHD with regard to diagnostic evaluation...
October 20, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29121971/cmr-based-blood-oximetry-via-multi-parametric-estimation-using-multiple-t2-measurements
#11
Juliet Varghese, Lee C Potter, Richard LaFountain, Xueliang Pan, Subha V Raman, Rizwan Ahmad, Orlando P Simonetti
BACKGROUND: Measurement of blood oxygen saturation (O2 saturation) is of great importance for evaluation of patients with many cardiovascular diseases, but currently there are no established non-invasive methods to measure blood O2 saturation in the heart. While T2-based CMR oximetry methods have been previously described, these approaches rely on technique-specific calibration factors that may not generalize across patient populations and are impractical to obtain in individual patients...
November 9, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/29118889/successful-treatment-of-iatrogenic-external-iliac-artery-perforation-with-covered-stent-case-report-and-review-of-the-literature
#12
Muhammad Umer Awan, Bassam Omar, Ghazanfar Qureshi, Ghulam Mustafa Awan
Retroperitoneal hemorrhage from iliac artery injury is a potentially serious complication of vascular interventional procedures leading to hemorrhagic shock and death if not diagnosed early and treated promptly. We report a 70-year-old male admitted to our facility with non-ST-elevation myocardial infarction, whose heart catheterization revealed left anterior descending artery (LAD) with 80% proximal, 95% mid and 100% distal disease. The left circumflex and right coronary arteries were 100% occluded proximally and received collaterals from the LAD...
October 2017: Cardiology Research
https://www.readbyqxmd.com/read/29117041/repeated-ramp-tests-on-stable-lvad-patients-reveal-patient-specific-hemodynamic-fingerprint
#13
Teruhiko Imamura, Daniel Burkhoff, Daniel Rodgers, Sirtaz Adatya, Nitasha Sarswat, Gene Kim, Jayant Raikhelkar, Takeyoshi Ota, Tae Song, Colleen Juricek, Valluvan Jeevanandam, Gabriel Sayer, Nir Uriel
Hemodynamic speed ramp tests are used in left ventricular assist device (LVAD) patients to guide speed adjustment and medical therapies. However, the reproducibility of these tests is unknown. In this prospective study, clinically stable LVAD patients underwent echocardiography and right heart catheterization ramp tests followed by a repeat test within 2 years as per institutional protocol. Sixteen patients (61.8 ± 10.5 years old, 50% male, eight with HeartMate II and eight with HVAD) underwent repeated ramp testing...
November 7, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29116574/successful-percutaneous-coronary-intervention-significantly-improves-coronary-sinus-blood-flow-as-assessed-by-transthoracic-echocardiography
#14
Radmila Lyubarova, William E Boden, Steven A Fein, Joshua Schulman-Marcus, Mikhail Torosoff
BACKGROUND: Transthoracic echocardiography (TTE) has been used to assess coronary sinus blood flow (CSBF), which reflects total coronary arterial blood flow. Successful angioplasty is expected to improve coronary arterial blood flow. Changes in CSBF after percutaneous coronary intervention (PCI), as assessed by TTE, have not been systematically evaluated. HYPOTHESIS: TTE can be utilized to reflect increased CSBF after a successful, clinically indicated PCI. METHODS: The study cohort included 31 patients (18 females, 62 ± 11 years old) referred for diagnostic cardiac catheterization for suspected coronary artery disease and possible PCI, when clinically indicated...
November 7, 2017: Journal of Echocardiography
https://www.readbyqxmd.com/read/29114731/association-of-cardiac-hemodynamic-factors-with-severity-of-white-matter-hyperintensities-in-chronic-valvular-heart-disease
#15
Woo-Jin Lee, Keun-Hwa Jung, Young Jin Ryu, Jeong-Min Kim, Soon-Tae Lee, Kon Chu, Manho Kim, Sang Kun Lee, Jae-Kyu Roh
Importance: The cerebral white matter hyperintensity (WMH) is frequently noted in patients with chronic heart disease. Long-term alteration of cardiac hemodynamics might have an influence on the mechanism of cerebral WMH. Objective: To investigate the association between chronically altered cardiac hemodynamics and severity of cerebral WMH in patients with chronic valvular heart disease. Design, Setting, and Participants: This cross-sectional analysis identified 303 consecutive patients at a tertiary referral center between 2008 and 2016 who were 50 years or older, and diagnosed with severe chronic valvular heart disease and underwent cardiac catherization, echocardiography, and received brain magnetic resonance imaging...
November 6, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/29111121/invasive-validation-of-the-echocardiographic-assessment-of-left-ventricular-filling-pressures-using-the-2016-diastolic-guidelines-head-to-head-comparison-with-the-2009-guidelines
#16
Bhavna Balaney, Diego Medvedofsky, Anuj Mediratta, Amita Singh, Boguslawa Ciszek, Eric Kruse, Atman P Shah, Karima Addetia, Roberto M Lang, Victor Mor-Avi
BACKGROUND: Recent American Society of Echocardiography (ASE)/European Association of Cardiovascular Imaging (EACVI) guidelines for echocardiographic evaluation of left ventricular (LV) diastolic function provide a practical, simplified diagnostic algorithm for estimating LV filling pressure. The aim of this study was to test the accuracy of this algorithm against invasively measured pressures and compare it with the accuracy of the previous 2009 guidelines in the same patient cohort...
October 27, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/29108668/the-prognostic-value-of-high-sensitivity-cardiac-troponin-t-in-patients-with-congenital-heart-disease
#17
Masayuki Abiko, Kei Inai, Eriko Shimada, Seiji Asagai, Toshio Nakanishi
BACKGROUND: Cardiac troponin T (cTnT) is a specific marker of myocardial injury that is elevated in patients with coronary artery disease or heart failure; it has been investigated as a prognostic marker. A highly sensitive, commercially available assay has been developed to detect cardiac troponin T (hs-cTnT). This study aimed to evaluate the clinical implications and prognostic value of hs-cTnT in patients with congenital heart disease (CHD). METHODS: We evaluated 122 consecutive patients hospitalized at our institution because of heart failure or scheduled cardiac catheterization...
November 3, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29107544/prognostic-relevance-of-right-heart-reverse-remodeling-in-idiopathic-pulmonary-arterial-hypertension
#18
Roberto Badagliacca, Roberto Poscia, Beatrice Pezzuto, Silvia Papa, Manuela Reali, Francesca Pesce, Giovanna Manzi, Daniele Gianfrilli, Francesco Ciciarello, Susanna Sciomer, Giuseppe Biondi-Zoccai, Roberto Torre, Francesco Fedele, Carmine Dario Vizza
BACKGROUND: Right ventricular (RV) failure is a major determinant of symptoms and shortened survival in pulmonary arterial hypertension (PAH). This study assessed the prognostic relevance of increased right heart (RH) dimensions determined by echocardiography and RH reverse remodeling (RHRR) with targeted therapies in idiopathic PAH (IPAH). METHODS: The study prospectively monitored 102 therapy-naïve IPAH patients for the presence of clinical worsening. Baseline evaluation included RH catheterization and echocardiography...
October 2, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29104831/coronary-artery-aneurysm-presenting-as-non-st-elevation-myocardial-infarction
#19
Murtaza Sundhu, Mehmet Yildiz, Bilal Saqi, Bilal Alam, Sidra Khalid, Emad Nukta
Coronary artery aneurysms are rare in the general population. There are no randomized control trials to guide the therapy at this moment. We present a case of a 52-year-old male who was recovering from addiction and was sober for past five years. He came to the hospital with typical chest pain. There were ST segment depressions in leads III and AVF. The second troponin was found to be elevated. The impression was non-ST-segment elevation myocardial infarction. He was started on subcutaneous enoxaparin and underwent left heart catheterization which revealed dilated ectatic coronary arteries with aneurysmal dilatation...
July 6, 2017: Curēus
https://www.readbyqxmd.com/read/29103472/performance-of-computed-tomography-derived-pulmonary-vasculature-metrics-in-the-diagnosis-and-haemodynamic-assessment-of-pulmonary-arterial-hypertension
#20
Kaoruko Shimizu, Ichizo Tsujino, Takahiro Sato, Ayako Sugimoto, Toshitaka Nakaya, Taku Watanabe, Hiroshi Ohira, Yoichi M Ito, Masaharu Nishimura
BACKGROUND: Few studies have addressed the value of combining computed tomography-derived pulmonary vasculature metrics for the diagnosis and haemodynamic evaluation of pulmonary arterial hypertension (PAH). MATERIALS AND METHODS: We measured three computed tomography parameters for the pulmonary artery, peripheral vessels, and pulmonary veins: the ratio of the diameter of the pulmonary artery to the aorta (PA/Ao), the cross-sectional area of small pulmonary vessels <5mm(2) as a percentage of total lung area (%CSA<5), and the diameter of the right inferior pulmonary vein (PVD)...
November 2017: European Journal of Radiology
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