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Exercise induced pulmonary hypertension

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https://www.readbyqxmd.com/read/28882941/anomalous-left-anterior-descending-artery-arising-from-the-pulmonary-trunk-a-rare-cause-of-angina
#1
Abdalla Ibrahim, Stephen P Power, Peter Kelly
A 60-year-old man with a medical history of hypertension and dyslipidaemia presented to our rapid access chest pain clinic with a 2-month history of chest pain on exertion. An exercise stress test was arranged, which showed electrical evidence of inducible ischaemia. Subsequently, a coronary angiogram revealed an anomalous left anterior descending artery arising from the main pulmonary artery that received grade 3 collaterals from a large right coronary artery arising from the aorta. The circumflex arises from the right coronary sinus with a retroaortic course and provided collaterals to the anomalous left anterior descending artery...
September 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28821335/symptoms-are-more-useful-than-echocardiography-in-patient-selection-for%C3%A2-pulmonary-endarterectomy
#2
Laura Donahoe, Rachel Vanderlaan, John Thenganatt, Karen McRae, Anastasia Bykova, Jakov Moric, John Granton, Marc de Perrot
BACKGROUND: Chronic thromboembolic pulmonary hypertension (CTEPH) is still largely underdiagnosed in the general population. Although transthoracic echocardiogram (TTE) is recommended to screen for CTEPH, it may not detect patients with chronic thromboembolic disease (CTED) and mild or exercise-induced pulmonary hypertension (PH) who could also benefit from pulmonary endarterectomy (PEA). METHODS: All patients referred to our CTEPH program with persistent mismatched perfusion defects on ventilation-perfusion (VQ) scan between January 2005 and June 2015 were divided into three groups according to TTE and right heart catheterization (RHC) as follows: (1) typical CTEPH group (PH on RHC and TTE), (2) TTE-negative (neg) CTEPH group (PH on RHC, but not TTE), or (3) CTED group (no PH on RHC and TTE)...
August 16, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28680584/use-of-thermodilution-cardiac-output-overestimates-diagnoses-of-exercise-induced-pulmonary-hypertension
#3
Steven Hsu, Samuel B Brusca, Parker S Rhodes, Todd M Kolb, Stephen C Mathai, Ryan J Tedford
Two new definitions of exercise-induced pulmonary hypertension (EIPH) have emerged. Both rely on measuring cardiac output (CO), yet this remains unstandardized. In our cohort of patients undergoing invasive cardiopulmonary exercise testing, we found that using thermodilution CO rather than direct Fick CO led to a significant excess of EIPH diagnoses.
March 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28596298/sex-differences-in-pulmonary-vascular-control-focus-on-the-nitric-oxide-pathway
#4
Daphne P M de Wijs-Meijler, A H Jan Danser, Irwin K M Reiss, Dirk J Duncker, Daphne Merkus
Although the incidence of pulmonary hypertension is higher in females, the severity and prognosis of pulmonary vascular disease in both neonates and adults have been shown to be worse in male subjects. Studies of sex differences in pulmonary hypertension have mainly focused on the role of sex hormones. However, the contribution of sex differences in terms of vascular signaling pathways regulating pulmonary vascular function remains incompletely understood. Consequently, we investigated pulmonary vascular function of male and female swine in vivo, both at rest and during exercise, and in isolated small pulmonary arteries in vitro, with a particular focus on the NO-cGMP-PDE5 pathway...
June 2017: Physiological Reports
https://www.readbyqxmd.com/read/28590298/diagnostic-and-prognostic-implications-of-exercise-treadmill-and-rest-first-pass-radionuclide-angiography-in-patients-with-pulmonary-hypertension
#5
Yen-Wen Wu, Pei-Ying Hsu, Yen-Hung Lin, Mei-Fang Cheng, Chi-Lun Ko, Yih-Hwen Huang, Ruoh-Fang Yen, Jin-Shing Chen, Jou-Wei Lin, Hsao-Hsun Hsu
PURPOSE: Pulmonary hypertension (PH) is characterized by abnormally increased pulmonary vascular pressure, leading to deteriorated right ventricular function and premature death. Pulmonary mean transit time (PMTT) and biventricular function response to exercise in first-pass radionuclide angiography (FP-RNA) may provide early detection and timely disease monitoring of PH. This study aimed to investigate the diagnostic and prognostic values of this imaging modality in PH patients. METHODS: Left and right ventricular ejection fraction (LVEF/RVEF) and PMTT at rest and immediately after exercise treadmill test were measured by FP-RNA in 77 consecutive patients with clinical presentations suggestive of PH (aged 46 ± 15 years, 33 men), mostly with symptoms of unexplained progressive dyspnea...
September 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28566298/colchicine-depolymerizes-microtubules-increases-junctophilin-2-and-improves-right-ventricular-function-in-experimental-pulmonary-arterial-hypertension
#6
Kurt W Prins, Lian Tian, Danchen Wu, Thenappan Thenappan, Joseph M Metzger, Stephen L Archer
BACKGROUND: Pulmonary arterial hypertension (PAH) is a lethal disease characterized by obstructive pulmonary vascular remodeling and right ventricular (RV) dysfunction. Although RV function predicts outcomes in PAH, mechanisms of RV dysfunction are poorly understood, and RV-targeted therapies are lacking. We hypothesized that in PAH, abnormal microtubular structure in RV cardiomyocytes impairs RV function by reducing junctophilin-2 (JPH2) expression, resulting in t-tubule derangements...
May 31, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28560534/exercise-testing-and-stress-imaging-in-aortic-valve-disease
#7
REVIEW
Luc A Pierard, Raluca Dulgheru
Aortic valve disease and especially aortic stenosis (AS) is a growing cardiac pathology. Aortic valve replacement (AVR) is still the only treatment with proven benefit on survival in symptomatic patients and in patients with a left ventricular ejection fraction (LVEF) <50%. The benefit of prophylactic AVR in asymptomatic patients is still unproven. Once symptoms develop, the prognosis worsens. Exercise testing has emerged as a tool to unmask the "pseudo-asymptomatic" patients with AS (those without self-reporting symptoms), to link "exercise induced dyspnea" more confidently and more objectively to aortic valve disease and to allow for a safe "watchful waiting strategy" in "pseudo-symptomatic" patients (those with dyspnea unrelated to aortic valve disease)...
July 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28287506/assessment-of-pulmonary-capillary-blood-volume-membrane-diffusing-capacity-and-intrapulmonary-arteriovenous-anastomoses-during-exercise
#8
Vincent Tedjasaputra, Sean van Diepen, Sophie É Collins, Wade M Michaelchuk, Michael K Stickland
Exercise is a stress to the pulmonary vasculature. With incremental exercise, the pulmonary diffusing capacity (DLCO) must increase to meet the increased oxygen demand; otherwise, a diffusion limitation may occur. The increase in DLCO with exercise is due to increased capillary blood volume (Vc) and membrane diffusing capacity (Dm). Vc and Dm increase secondary to the recruitment and distension of pulmonary capillaries, increasing the surface area for gas exchange and decreasing pulmonary vascular resistance, thereby attenuating the increase in pulmonary arterial pressure...
February 20, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28181133/effects-of-aerobic-exercise-training-on-metabolism-of-nitric-oxide-and-endothelin-1-in-lung-parenchyma-of-rats-with-pulmonary-arterial-hypertension
#9
A Zimmer, R B Teixeira, J H P Bonetto, R Siqueira, C C Carraro, L M Donatti, A Hickmann, I E Litvin, A E G Godoy, A S Araujo, R Colombo, Adriane Belló-Klein
Pulmonary arterial hypertension (PAH) is characterized by vasoconstriction and proliferative obstruction of pulmonary vessels, which promotes a progressive increase in pulmonary vascular resistance (PVR). The effect of exercise training on oxidative stress, metabolism, and markers of nitric oxide (NO) and endothelin-1 (ET-1) was analyzed in the lung tissue of rats with PAH induced by monocrotaline (MCT).Twenty-four Wistar rats were divided into four groups (5-7 animals): sedentary control (SC), sedentary MCT (SM), trained control (TC), and trained MCT (TM)...
May 2017: Molecular and Cellular Biochemistry
https://www.readbyqxmd.com/read/28178968/imatinib-relaxes-the-pulmonary-venous-bed-of-guinea-pigs
#10
Nina A Maihöfer, Said Suleiman, Daniela Dreymüller, Paul W Manley, Rolf Rossaint, Stefan Uhlig, Christian Martin, Annette D Rieg
BACKGROUND: Recently, the IMPRES study revealed that systemic imatinib improves exercise capacity in patients with advanced pulmonary arterial hypertension. Imatinib blocks the tyrosine kinase activity of the platelet-derived growth factor (PDGF)-receptor (PDGFR), acts antiproliferative and relaxes pulmonary arteries. However so far, the relaxant effects of imatinib on pulmonary veins (PVs) and on the postcapillary resistance are unknown, although pulmonary hypertension (PH) due to left heart disease (LHD) is most common and primarily affects PVs...
February 8, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28132404/right-ventricular-function-during-acute-exacerbation-of-severe-equine-asthma
#11
A Decloedt, H Borowicz, M Slowikowska, K Chiers, G van Loon, A Niedzwiedz
BACKGROUND: Pulmonary hypertension has been described in horses with severe equine asthma, but its effect on the right ventricle has not been fully elucidated. OBJECTIVES: To evaluate right ventricular structure and function after a 1-week period of pulmonary hypertension secondary to acute exacerbation of severe equine asthma. STUDY DESIGN: Prospective study. METHODS: A clinical episode of severe equine asthma was induced experimentally in six susceptible horses...
September 2017: Equine Veterinary Journal
https://www.readbyqxmd.com/read/28131663/pulmonary-hypertension-and-ventilation-during-exercise-role-of-the-pre-capillary-component
#12
Sergio Caravita, Andrea Faini, Gael Deboeck, Antoine Bondue, Robert Naeije, Gianfranco Parati, Jean-Luc Vachiéry
BACKGROUND: Excessive exercise-induced hyperventilation and high prevalence of exercise oscillatory breathing (EOB) are present in patients with post-capillary pulmonary hypertension (PH) complicating left heart disease (LHD). Patients with pre-capillary PH have even higher hyperventilation but no EOB. We sought to determine the impact of a pre-capillary component of PH on ventilatory response to exercise in patients with PH and left heart disease. METHODS: We retrospectively compared patients with idiopathic or heritable pulmonary arterial hypertension (PAH, n = 29), isolated post-capillary PH (IpcPH, n = 29), and combined post- and pre-capillary PH (CpcPH, n = 12)...
December 23, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28117249/downhill-exercise-training-in-monocrotaline-injected-rats-effects-on-echocardiographic-and-haemodynamic-variables-and-survival
#13
Irina Enache, Fabrice Favret, Stéphane Doutreleau, Paola Goette Di Marco, Anne-Laure Charles, Bernard Geny, Anne Charloux
BACKGROUND: Eccentric exercise training has been shown to improve muscle force strength without excessive cardiovascular stress. Such an exercise modality deserves to be tested in pulmonary arterial hypertension. AIM: We aimed to assess the effects of an eccentric training modality on cardiac function and survival in an experimental monocrotaline-induced model of pulmonary arterial hypertension with right ventricular dysfunction. METHODS: Forty rats were randomly assigned to one of four groups: 40mg/kg monocrotaline-injected sedentary rats; 40mg/kg monocrotaline-injected eccentric-trained rats; sedentary control rats; or eccentric-trained control rats...
February 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28071674/predictors-of-exercise-induced-pulmonary-hypertension-in-patients-with-asymptomatic-degenerative-mitral-regurgitation-mechanistic-insights-from-2d-speckle-tracking-echocardiography
#14
Ryo Kamijima, Kengo Suzuki, Masaki Izumo, Shingo Kuwata, Kei Mizukoshi, Manabu Takai, Seisyou Kou, Akio Hayashi, Keisuke Kida, Tomoo Harada, Yoshihiro J Akashi
Presence of exercise-induced pulmonary hypertension (EIPH) in asymptomatic degenerative mitral regurgitation (DMR) determines prognosis. This study aimed to elucidate the mechanism and predictors of EIPH in asymptomatic DMR. Ninety-one consecutive asymptomatic patients with DMR who underwent exercise stress echocardiography were prospectively included. We obtained various conventional echocardiographic parameters at rest and during peak exercise, as well as left atrial (LA) function at rest using 2-dimensional speckle-tracking analysis...
January 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28054496/tailoring-exercise-interventions-to-comorbidities-and-treatment-induced-adverse-effects-in-patients-with-early-stage-breast-cancer-undergoing-chemotherapy-a-framework-to-support-clinical-decisions
#15
Marike van der Leeden, Rosalie J Huijsmans, Edwin Geleijn, Mariëtte de Rooij, Inge R Konings, Laurien M Buffart, Joost Dekker, Martijn M Stuiver
PURPOSE: Delivery of exercise interventions to patients with early-stage breast cancer undergoing chemotherapy requires complex clinical decisions. The purpose of this study was to develop a framework to support clinical decisions for tailoring exercise interventions to common comorbidities and cancer treatment-induced adverse effects. METHOD: Tailored exercise prescriptions were developed in four steps, following the i3-S strategy. All steps were based on current best available evidence, complemented with expert opinions...
January 5, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/27940957/magnetic-resonance-augmented-cardiopulmonary-exercise-testing-comprehensively-assessing-exercise-intolerance-in-children-with-cardiovascular-disease
#16
Nathaniel J Barber, Emmanuel O Ako, Gregorz T Kowalik, Mun H Cheang, Bejal Pandya, Jennifer A Steeden, Shahin Moledina, Vivek Muthurangu
BACKGROUND: Conventional cardiopulmonary exercise testing can objectively measure exercise intolerance but cannot provide comprehensive evaluation of physiology. This requires additional assessment of cardiac output and arteriovenous oxygen content difference. We developed magnetic resonance (MR)-augmented cardiopulmonary exercise testing to achieve this goal and assessed children with right heart disease. METHODS AND RESULTS: Healthy controls (n=10) and children with pulmonary arterial hypertension (PAH; n=10) and repaired tetralogy of Fallot (n=10) underwent MR-augmented cardiopulmonary exercise testing...
December 2016: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27920514/usefulness-of-the-6-minute-walk-test-as-a-screening-test-for-pulmonary-arterial-enlargement-in-copd
#17
Yutaro Oki, Masahiro Kaneko, Yukari Fujimoto, Hideki Sakai, Shogo Misu, Yuji Mitani, Takumi Yamaguchi, Hisafumi Yasuda, Akira Ishikawa
PURPOSE: Pulmonary hypertension and exercise-induced oxygen desaturation (EID) influence acute exacerbation of COPD. Computed tomography (CT)-detected pulmonary artery (PA) enlargement is independently associated with acute COPD exacerbations. Associations between PA to aorta (PA:A) ratio and EID in patients with COPD have not been reported. We hypothesized that the PA:A ratio correlated with EID and that results of the 6-minute walk test (6MWT) would be useful for predicting the risk associated with PA:A >1...
2016: International Journal of Chronic Obstructive Pulmonary Disease
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
#18
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...
February 1, 2017: 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
#19
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...
January 2017: 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
#20
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...
February 1, 2017: International Journal of Cardiology
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