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Exercise induced pulmonary hypertension

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https://www.readbyqxmd.com/read/27913427/intermittent-hypoxia-during-recovery-from-neonatal-hyperoxic-lung-injury-causes-long-term-impairment-of-alveolar-development-a-new-rat-model-of-bpd
#1
Anastasiya Mankouski, Crystal Kantores, Mathew J Wong, Julijana Ivanovska, Amish Jain, Eric J Benner, Stanley N Mason, A Keith Tanswell, Richard L Auten, Robert P Jankov
Bronchopulmonary dysplasia (BPD) is a chronic lung injury characterized by impaired alveologenesis that may persist into adulthood. Rat models of BPD using varying degrees of hyperoxia to produce injury either cause early mortality or spontaneously recover following removal of the inciting stimulus, thus limiting clinical relevance. We sought to refine an established rat model induced by exposure to 60% O2 from birth by following hyperoxia with intermittent hypoxia (IH). Rats exposed from birth to air or 60% O2 until day 14 were recovered in air with or without IH (FiO2 = 0...
December 2, 2016: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/27878925/left-ventricular-deformation-at-rest-predicts-exercise-induced-elevation-in-pulmonary-artery-wedge-pressure-in-patients-with-unexplained-dyspnoea
#2
Tor Biering-Sørensen, Mário Santos, Jose Rivero, Shane D McCullough, Erin West, Alexander R Opotowsky, Aaron B Waxman, David M Systrom, Amil M Shah
AIMS: Impaired left ventricular (LV) deformation despite preserved LV ejection fraction (LVEF) is common and predicts outcomes in heart failure with preserved LVEF. We hypothesized that impaired LV deformation at rest is a marker of impaired cardiac systolic and diastolic reserve, and aimed to determine whether resting longitudinal (LS) and circumferential strain (CS) are associated with invasively measured haemodynamic response to exercise in patients with dyspnoea and a normal LVEF...
November 22, 2016: European Journal of Heart Failure
https://www.readbyqxmd.com/read/27875728/exercise-induced-pulmonary-hypertension-by-stress-echocardiography-prevalence-and-correlation-with-right-heart-hemodynamics
#3
Deepika Misra, Ante Kendes, Roxana Sulica, Blase Carabello
OBJECTIVES: The aim of this study was to determine the prevalence of exercise-induced pulmonary hypertension (EIPH) in consecutive subjects referred for stress echocardiography for chest pain or shortness of breath and correlate echocardiographic diagnosis of EIPH with hemodynamics at right heart catheterization (RHC). BACKGROUND: Elevated pulmonary pressure can lead to significant morbidity and mortality. EIPH by ehocardiography has been described in patients with connective tissue disease...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27851698/nitrite-prevents-right-ventricular-failure-and-remodeling-induced-by-pulmonary-artery-banding
#4
Jian Hu, Maryam Sharifi-Sanjani, Stevan P Tofovic
BACKGROUND: Nitrite has been shown to reduce right ventricle (RV) remodeling in experimental pulmonary hypertension. However, whether this effect is due to a reduction in RV afterload (i.e., reduction in pulmonary artery pressure) or a direct effect on the RV itself remains unanswered. We hypothesize that nitrite has direct effects on RV remodeling and studied its effects in mice with pulmonary artery banding (PAB). METHODS AND RESULTS: PAB decreased exercise tolerance, and reduced RV systolic and diastolic function...
November 14, 2016: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/27836751/activation-of-gper-ameliorates-experimental-pulmonary-hypertension-in-male-rats
#5
Allan K Alencar, Guilherme C Montes, Tadeu Montagnoli, Ananssa M S Silva, Sabrina T Martinez, Aline G Fraga, Hao Wang, Leanne Groban, Roberto T Sudo, Gisele Zapata-Sudo
RATIONALE: Pulmonary hypertension (PH) is characterized by pulmonary vascular remodeling that leads to pulmonary congestion, uncompensated right-ventricle (RV) failure, and premature death. Preclinical studies have demonstrated that the G protein-coupled estrogen receptor (GPER) is cardioprotective in male rats and that its activation elicits vascular relaxation in rats of either sex. OBJECTIVES: To study the effects of GPER on the cardiopulmonary system by the administration of its selective agonist G1 in male rats with monocrotaline (MCT)-induced PH...
November 8, 2016: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/27824602/exercise-pulmonary-haemodynamics-predict-outcome-in-patients-with-systemic-sclerosis
#6
Adriana Stamm, Stéphanie Saxer, Mona Lichtblau, Elisabeth D Hasler, Suzana Jordan, Lars C Huber, Konrad E Bloch, Oliver Distler, Silvia Ulrich
The aim of the present study was to investigate the prognostic value of exercise haemodynamics measured during right heart catheterisation (RHC) in patients with systemic sclerosis (SSc) referred for evaluation of pulmonary hypertension.SSc patients undergoing RHC at rest and during maximal supine incremental cycle exercise were grouped into resting precapillary pulmonary hypertension (PHrest) (mean pulmonary artery pressure (mPAP) ≥25 mmHg, pulmonary artery wedge pressure <15 mmHg), exercise-induced pulmonary hypertension (PHex) (mPAP ≥30 mmHg and mPAP/cardiac output >3 mmHg·L(-1)·min(-1) at maximal exercise), and without pulmonary hypertension (PHnone)...
December 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/27784688/high-intensity-interval-training-but-not-continuous-training-reverses-right-ventricular-hypertrophy-and-dysfunction-in-a-rat-model-of-pulmonary-hypertension
#7
Mary Beth Brown, Evandro Neves, Gary Marshall Long, Jeremy Bryce Graber, Brett Alexandria Gladish, Andrew Wiseman, Matthew Owens, Amanda Jo Fisher, Robert Gray Presson, Irina Petrache, Jeffrey A Kline, Tim Lahm
BACKGROUND: Exercise is beneficial in pulmonary arterial hypertension (PAH), although studies to date indicate little effect on the elevated pulmonary pressures or maladaptive RV hypertrophy associated with the disease. For chronic LV failure, high intensity interval training (HIIT) promotes greater endothelial stimulation and superior benefit than customary continuous exercise training (CExT); however, HIIT has not been tested for PAH. Therefore, here we investigated acute and chronic responses to HIIT vs...
October 26, 2016: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/27754275/sy-18-1-translational-research-in-pah
#8
Wook-Jin Chung
Pulmonary arterial hypertension (PAH) is a life-threatening disorder with a poor prognosis and causes pulmonary vascular remodeling accompanied with increased pulmonary arterial medial wall thickness and fibrosis, which leads to vascular and right ventricular (RV) dysfunction. Despite treatment with prostacyclin, endothelin antagonist, and phosphodiesterase-5 inhibitors the 1-year mortality rate of PAH still remains high. Recent registries, clinical trials, and basic researches have been increasing the knowledge of PAH and it would contribute to potential therapeutic strategies and better clinical outcome...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27737768/ventricular-arterial-coupling-and-exercise-induced-pulmonary-hypertension-during-low-level-exercise-in-heart-failure-with-preserved-or-reduced-ejection-fraction
#9
Masaru Obokata, Yasufumi Nagata, Yuichiro Kado, Masahiko Kurabayashi, Yutaka Otsuji, Masaaki Takeuchi
BACKGROUND: Exercise-induced pulmonary hypertension (EIPH) may develop even at low workloads in heart failure (HF) patients. Ventricular-arterial stiffening plays an important role in the pathophysiology of HF with preserved ejection fraction (HFpEF). This study aimed to compare the response of ventricular-arterial coupling and PH during low-level exercise between HFpEF and HF with reduced EF (HFrEF). METHODS AND RESULTS: Echocardiography was performed at rest and during 10 W of bicycle exercise in HFpEF (n=37) and HFrEF (n=43)...
October 10, 2016: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/27696506/echocardiographic-assessment-of-right-ventricular-contractile-reserve-in-healthy-subjects
#10
Michele D'Alto, Adriana Pavelescu, Paola Argiento, Emanuele Romeo, Anna Correra, Giovanni Maria Di Marco, Antonello D'Andrea, Berardo Sarubbi, Maria Giovanna Russo, Robert Naeije
BACKGROUND: Exercise-induced increase in pulmonary artery systolic pressure (PASP) as a possible measure of right ventricular (RV) contractile reserve has been shown to predict survival in severe pulmonary hypertension. However, RV contractile reserve can also be measured by changes in stroke volume (SV), tricuspid annular plane systolic excursion (TAPSE), or tricuspid annular systolic velocity (S'). The limits of normal values and the functional significance of these changes in healthy subjects are not well known...
October 2, 2016: Echocardiography
https://www.readbyqxmd.com/read/27679601/clinical-characteristics-and-determinants-of-exercise-induced-pulmonary-hypertension-in-patients-with-preserved-left-ventricular-ejection-fraction
#11
A Young Lim, Chunghun Kim, Sung-Ji Park, Jin-Oh Choi, Sang-Chol Lee, Seung Woo Park
AIMS: Recent studies have shown that exercise-induced pulmonary hypertension (EIPH) is not rare in patients with preserved left ventricular ejection fraction (LVEF). However, the determinants and clinical implication of EIPH in these patients are unclear. METHODS AND RESULTS: This study included 1383 patients who were referred for exercise echocardiography to evaluate unexplained exertional dyspnoea or chest discomfort. Pulmonary artery systolic pressure (PASP) was estimated from the maximal velocity of the tricuspid regurgitant jet added to a right atrial pressure of 10 mmHg...
September 27, 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/27643272/sy-18-1-translational-research-in-pah
#12
Wook-Jin Chung
Pulmonary arterial hypertension (PAH) is a life-threatening disorder with a poor prognosis and causes pulmonary vascular remodeling accompanied with increased pulmonary arterial medial wall thickness and fibrosis, which leads to vascular and right ventricular (RV) dysfunction. Despite treatment with prostacyclin, endothelin antagonist, and phosphodiesterase-5 inhibitors the 1-year mortality rate of PAH still remains high. Recent registries, clinical trials, and basic researches have been increasing the knowledge of PAH and it would contribute to potential therapeutic strategies and better clinical outcome...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27613549/the-right-ventricle-interaction-with-the-pulmonary-circulation
#13
REVIEW
Michael R Pinsky
The primary role of the right ventricle (RV) is to deliver all the blood it receives per beat into the pulmonary circulation without causing right atrial pressure to rise. To the extent that it also does not impede left ventricular (LV) filling, cardiac output responsiveness to increased metabolic demand is optimized. Since cardiac output is a function of metabolic demand of the body, during stress and exercise states the flow to the RV can vary widely. Also, instantaneous venous return varies widely for a constant cardiac output as ventilatory efforts alter the dynamic pressure gradient for venous return...
September 10, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27475894/right-ventricular-and-pulmonary-vascular-reserve-in-asymptomatic-bmpr2-mutation-carriers
#14
Guido Claessen, Andre La Gerche, Thibault Petit, Hilde Gillijns, Jan Bogaert, Mathias Claeys, Steven Dymarkowski, Piet Claus, Marion Delcroix, Hein Heidbuchel
BACKGROUND: Non-invasive estimates have suggested that asymptomatic BMPR2 mutation carriers may have an abnormal pulmonary vascular response to exercise and hypoxia. However, this has not been assessed with "gold standard" invasive measures. METHODS: Eight controls and 8 asymptomatic BMPR2 mutation carriers underwent cardiac magnetic resonance imaging with simultaneous invasive pressure recording during bicycle exercise in normoxia, hypoxia and after sildenafil administration...
June 24, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27425465/cardiopulmonary-protective-effects-of-the-selective-fxr-agonist-obeticholic-acid-in-the-rat-model-of-monocrotaline-induced-pulmonary-hypertension
#15
Linda Vignozzi, Annamaria Morelli, Ilaria Cellai, Sandra Filippi, Paolo Comeglio, Erica Sarchielli, Elena Maneschi, Gabriella Barbara Vannelli, Luciano Adorini, Mario Maggi
Farnesoid X receptor (FXR) activation by obeticholic acid (OCA) has been demonstrated to inhibit inflammation and fibrosis development and even induce fibrosis regression in liver, kidney and intestine in multiple disease models. OCA also inhibits liver fibrosis in nonalcoholic steatohepatitis patients. FXR activation has also been demonstrated to suppress the inflammatory response and to promote lung repair after lung injury. This study investigated the effects of OCA treatment (3, 10 or 30mg/kg, daily for 5days a week, for 7 and/or 28 days) on inflammation, tissue remodeling and fibrosis in the monocrotaline (MCT)-induced pulmonary arterial hypertension (PAH) rat model...
January 2017: Journal of Steroid Biochemistry and Molecular Biology
https://www.readbyqxmd.com/read/27420025/new-insights-into-mechanisms-regulating-pulmonary-adventitial-fibroblast-proliferation
#16
Roy L Sutliff
In this issue of Acta Physiologica Scandinavica Li et al, make important contributions to the field of pulmonary hypertension by advancing our understanding of the molecular mechanisms that drive hypoxia-induced proliferation of adventitial fibroblasts PAFs (REF). Pulmonary hypertension (PH) is defined as an elevation of mean pulmonary artery pressure above 25 mm Hg at rest or above 30 mm Hg with exercise and is characterized by a narrowing of the pulmonary vasculature (Barst, 2008, Rabinovitch, 2012). The increase in pulmonary vascular resistance and pressure increases right ventricular afterload and the pressure required to force blood through the narrowed pulmonary vascular bed...
July 15, 2016: Acta Physiologica
https://www.readbyqxmd.com/read/27381367/the-principal-pathways-involved-in-the-in%C3%A2-vivo-modulation-of-hypoxic-pulmonary-vasoconstriction-pulmonary-arterial-remodelling-and-pulmonary-hypertension
#17
D Kylhammar, G Rådegran
Hypoxic pulmonary vasoconstriction (HPV) serves to optimize ventilation-perfusion matching in focal hypoxia and thereby enhances pulmonary gas exchange. During global hypoxia, however, HPV induces general pulmonary vasoconstriction, which may lead to pulmonary hypertension (PH), impaired exercise capacity, right-heart failure and pulmonary oedema at high altitude. In chronic hypoxia, generalized HPV together with hypoxic pulmonary arterial remodelling, contribute to the development of PH. The present article reviews the principal pathways in the in vivo modulation of HPV, hypoxic pulmonary arterial remodelling and PH with primary focus on the endothelin-1, nitric oxide, cyclooxygenase and adenine nucleotide pathways...
July 6, 2016: Acta Physiologica
https://www.readbyqxmd.com/read/27377832/heart-rate-response-during-6-minute-walking-testing-predicts-outcome-in-operable-chronic-thromboembolic-pulmonary-hypertension
#18
Manuel Jonas Richter, Katrin Milger, Khodr Tello, Philipp Stille, Werner Seeger, Eckhard Mayer, Hossein A Ghofrani, Henning Gall
BACKGROUND: Six-minute walk test (6MWT) is routinely performed in chronic thromboembolic pulmonary hypertension (CTEPH) before pulmonary endarterectomy (PEA). However, the clinical relevance of heart rate response (ΔHR) and exercise-induced oxygen desaturation (EID) during 6MWT is remaining unknown. METHODS: Patients undergoing PEA in our center between 03/2013-04/2014 were assessed prospectively with hemodynamic and exercise parameters prior to and 1 year post-PEA...
2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27372842/hemodynamic-and-ventilatory-responses-during-exercise-in-chronic-thromboembolic-disease
#19
Coen van Kan, Mart N van der Plas, Herre J Reesink, Reindert P van Steenwijk, Jaap J Kloek, Robert Tepaske, Peter I Bonta, Paul Bresser
BACKGROUND: Patients with chronic thromboembolic disease (CTED) may suffer from exercise intolerance without pulmonary hypertension at rest. Pulmonary endarterectomy (PEA) for symptomatic CTED results in improvement of symptoms and quality of life. Neither the pathophysiology of the exercise limitation nor the underlying mechanisms of the PEA-induced improvement have been studied previously. OBJECTIVES: We studied hemodynamic and ventilatory responses upon exercise in 14 patients with CTED...
September 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27368695/exercise-echocardiography-for-the-assessment-of-pulmonary-hypertension-in-systemic-sclerosis-a-systematic-review
#20
Rui Baptista, Sara Serra, Rui Martins, Rogério Teixeira, Graça Castro, Maria João Salvador, José António Pereira da Silva, Lèlita Santos, Pedro Monteiro, Mariano Pêgo
BACKGROUND: Pulmonary arterial hypertension (PAH) complicates the course of systemic sclerosis (SSc) and is associated with poor prognosis. The elevation of systolic pulmonary arterial pressure (sPAP) during exercise in patients with SSc with normal resting haemodynamics may anticipate the development of PAH. Exercise echocardiography (ExEcho) has been proposed as a useful technique to identify exercise-induced increases in sPAP, but it is unclear how to clinically interpret these findings...
2016: Arthritis Research & Therapy
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