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Pulmonary artery hypertension

Junjing Su, Charmilie C Logan, Alun D Hughes, Kim H Parker, Niti M Dhutia, Carl Christian Danielsen, Ulf Simonsen
Arterial stiffness and wave reflection are important components of the ventricular afterload. Therefore, we aimed to assess the arterial wave characteristics and mechanical properties of the proximal pulmonary arteries (PAs) in the hypoxic pulmonary hypertensive rat model. After 21 days in normoxic or hypoxic chambers (24 animals in each group), the animals underwent transthoracic echocardiography and pulmonary artery catheterization with a dual-tipped pressure and Doppler flow sensor wire. Wave intensity analysis (WIA) was performed...
March 16, 2018: American Journal of Physiology. Heart and Circulatory Physiology
Fedir N Kiskin, C-Hong Chang, Christopher J Z Huang, Baraa Kwieder, Christine Cheung, Benjamin J Dunmore, Felipe Serrano, Sanjay Sinha, Nicholas W Morrell, Amer A Rana
No abstract text is available yet for this article.
March 16, 2018: American Journal of Respiratory and Critical Care Medicine
Rasa Tamosiuniene, Olga Manouvakhova, Paul Mesange, Toshie Saito, Jin Qian, Mrinmoy Sanyal, Yu-Chun Lin, Linh P Nguyen, Amir Luria, Allen B Tu, Joshua M Sante, Marlene Rabinovitch, Desmond J Fitzgerald, Brian B Graham, Aida Habtezion, Norbert F Voelkel, Laure Aurelian, Mark R Nicolls
<u>Rationale:</u> Pulmonary arterial hypertension (PH) is a life-threatening condition associated with immune dysregulation and abnormal regulatory T cell (Treg) activity, but it is currently unknown whether and how abnormal Treg function differentially affects males and females. <u>Objective:</u> To evaluate whether and how Treg-deficiency differentially affects male and female rats in experimental PH. <u>Methods and Results:</u> Male and female athymic rnu/rnu rats, lacking Tregs, were treated with the vascular endothelial growth factor receptor-2 (VEGFR2) inhibitor SU5416 or chronic hypoxia and evaluated for PH; some animals underwent Treg immune reconstitution (IR) before SU5416 administration...
March 15, 2018: Circulation Research
Julio Sandoval
Despite advances in drug therapy, pulmonary hypertension-particularly arterial hypertension (PAH)-remains a fatal disease. Untreatable right heart failure (RHF) from PAH eventually ensues and remains a significant cause of death in these patients. Lowering pulmonary input impedance with different PAH-specific drugs is the obvious therapeutic target in RHF due to chronically increased afterload. However, potential clinical gain can also be expected from attempts to unload the right heart and increase systemic output...
March 12, 2018: Revista Española de Cardiología
Johannes Krämer, Felix Kreuzer, Michael Kaestner, Peter Bride, Fabian von Scheidt, Jannos Siaplaouras, Heiner Latus, Dietmar Schranz, Christian Apitz
Right ventricular (RV) hypertrophy is regarded as the adaptation on chronic RV pressure load in pulmonary hypertension. As the RV Sokolow-Lyon index (RVSLI) is an electrocardiographic marker of RV hypertrophy, we hypothesized that RVSLI might be able to reflect RV pressure load. Therefore, the purpose of this study was to characterize the diagnostic impact of the RVSLI in children with idiopathic pulmonary arterial hypertension (IPAH) in order to assess disease severity and to evaluate its value for the prediction of worse outcome...
March 14, 2018: Pediatric Cardiology
Rebecca R Vanderpool, Melissa Saul, Mehdi Nouraie, Mark T Gladwin, Marc A Simon
Importance: Heart failure with preserved ejection fraction (HFpEF) is highly prevalent, yet there are no specific therapies, possibly due to phenotypic heterogeneity. The development of pulmonary hypertension (PH) in patients with HFpEF is considered a high-risk phenotype in need of targeted therapies, but there have been limited hemodynamic and outcomes data. Objective: To identify the hemodynamic characteristics and outcomes of PH-HFpEF. Design, Setting, and Participants: Cohort study of participants who had a right heart catheterization from January 2005 to September 2012 (median [interquartile range] follow-up time, 1578 [554-2513] days) were analyzed...
March 14, 2018: JAMA Cardiology
Thenappan Thenappan, Mark L Ormiston, John J Ryan, Stephen L Archer
Pulmonary hypertension is defined as a resting mean pulmonary artery pressure of 25 mm Hg or above. This review deals with pulmonary arterial hypertension (PAH), a type of pulmonary hypertension that primarily affects the pulmonary vasculature. In PAH, the pulmonary vasculature is dynamically obstructed by vasoconstriction, structurally obstructed by adverse vascular remodeling, and pathologically non-compliant as a result of vascular fibrosis and stiffening. Many cell types are abnormal in PAH, including vascular cells (endothelial cells, smooth muscle cells, and fibroblasts) and inflammatory cells...
March 14, 2018: BMJ: British Medical Journal
Claudio Caviezel, Carlson Aruldas, Daniel Franzen, Silvia Ulrich, Ilhan Inci, Didier Schneiter, Walter Weder, Isabelle Opitz
OBJECTIVES: Pulmonary hypertension (PH) is considered a contraindication for lung volume reduction surgery (LVRS). Because, it has been reported that endobronchial lung volume reduction may have a beneficial effect without increased mortality in patients with emphysema and PH, we evaluated its effect on PH in patients undergoing LVRS. METHODS: From January 2014 until June 2016, 119 LVRSs were performed at Zurich University Hospital. PH was a contraindication for patients with homogeneous emphysema but was acceptable for those with heterogeneous emphysema...
March 12, 2018: European Journal of Cardio-thoracic Surgery
Chien-Hua Chen, Cheng-Li Lin, Chia-Hung Kao
We assessed the subsequent risk of cholelithiasis development in patients with inflammatory bowel diseases (IBDs) such as Crohn's disease (CD) or ulcerative colitis (UC). We identified 8186 patients who aged ≥20 years and were diagnosed with IBD between 2000 and 2010 as the study cohort. A total of 8186 patients without IBD were selected by frequency-matching according to age, sex, comorbidities, and the index date of diagnosis, and they were identified as the control cohort. To measure the incidence of cholelithiasis, all patients were followed up until the end of 2011...
March 14, 2018: International Journal of Environmental Research and Public Health
Zhi-Chun Gu, Yi-Jing Zhang, Mang-Mang Pan, Chi Zhang, Xiao-Yan Liu, An-Hua Wei, Ying-Jie Su
BACKGROUND: Pulmonary arterial hypertension (PAH) is a progressive disease and ultimately leads to right heart failure. Endothelin receptor antagonists (ERAs) have been demonstrated to significantly improve prognosis in PAH. However, ERAs-induced side effects can result in poor patient tolerance. Thus, we aim to evaluate current safety evidence of ERAs in PAH. METHODS: An electronic search will be performed for randomized controlled trials (RCTs) that reported the interested safety data (abnormal liver function, peripheral edema, and anemia) of ERAs in PAH...
March 2018: Medicine (Baltimore)
Rebecca R Vanderpool, Robert Naeije
The diagnosis and evaluation of severity of pulmonary vascular disease rests on the invasive determination of a pulmonary vascular resistance (PVR). It is often overlooked that PVR is linearly related to the viscosity of the blood, which in turn is curvilinearly related to hematocrit. We propose a correction diagram for patients with anemia or with polycythemia. Based on a distensibility model of the pulmonary circulation, we show that magnitude of hematocrit correction of PVR is increased in proportion to pulmonary artery wedge pressure (PAWP) and the measured levels of PVR or hematocrit, and decreased in case of preserved resistive vessel distensibility and absence of pulmonary hypertension...
March 14, 2018: American Journal of Respiratory and Critical Care Medicine
Kishan S Parikh, Michael P Gray, Lewis J Rubin, David Badesch, Richard A Krasuski
No abstract text is available yet for this article.
January 2018: Pulmonary Circulation
H Y Ruan, Y G Zhang, R Liu
Objective: To compare the acute hemodynamic effects of intravenous fasudil with different dosage on patients with congenital heart defects (CHD) and severe pulmonary arterial hypertension (PAH). Methods: Sixty patients (37±17 years old) with CHD and PAH were consecutively enrolled. All patients underwent heart catheterization. The patients were randomly divided into two groups: the regular dosage group and the large dosage group. At initiation and 30 min after intravenous fasudil(30 mg and 60 mg respectively), the following hemodynamic parameters were measured and calculated: right atrial pressure(RAP), pulmonary arterypressure(PAP) , systemic artery pressure (SAP), pulmonary capillary wedge pressure(PCWP) , pulmonary vascular resistance(PVR) and systemic vascular resistance( SVR), cardiac index (CI) and artery oxygen saturation (SaO(2))...
March 6, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Yuchi Han, Paul R Forfia, Anjali Vaidya, Jeremy A Mazurek, Myung H Park, Gautam Ramani, Stephen Y Chan, Aaron B Waxman
Introduction: A major determining factor on outcomes in patients with pulmonary arterial hypertension (PAH) is right ventricular (RV) function. Ranolazine, which is currently approved for chronic stable angina, has been shown to improve RV function in an animal model and has been shown to be safe in small human studies with PAH. We aim to study the effect of ranolazine on RV function using cardiovascular magnetic resonance (CMR) in patients with pulmonary hypertension (non-group 2 patients) and monitor the effect of ranolazine on metabolism using metabolic profiling and changes of microRNA...
2018: Open Heart
Marian Urban, Karen Booth, John O'Sullivan, John Dark
We present a case of young female patient with end stage lung failure due to pulmonary arterial hypertension who was failing maximal medical therapy and was listed for a single sequential lung transplantation. The challenge of the case was a concomitant presence of a large atrial septal defect (ASD). The novelty of our approach was a device closure of ASD before performing a transplant with the use of intraoperative venoarterial extracorporeal membrane oxygenation (ECMO).
March 9, 2018: Annals of Thoracic Surgery
Benjamin J Currie, Chris Johns, Matthew Chin, Thanos Charalampopolous, Charlie A Elliot, Pankaj Garg, Smitha Rajaram, Catherine Hill, Jim W Wild, Robin A Condliffe, David G Kiely, Andy J Swift
BACKGROUND: Patients with pulmonary hypertension due to left heart disease (PH-LHD) have overlapping clinical features with pulmonary arterial hypertension making diagnosis reliant on right heart catheterization (RHC). This study aimed to investigate computed tomography pulmonary angiography (CTPA) derived cardiopulmonary structural metrics, in comparison to magnetic resonance imaging (MRI) for the diagnosis of left heart disease in patients with suspected pulmonary hypertension. METHODS: Patients with suspected pulmonary hypertension who underwent CTPA, MRI and RHC were identified...
March 4, 2018: International Journal of Cardiology
Jahidur Rashid, Kamrun Nahar, Snehal Raut, Ali Keshavarz, Fakhrul Ahsan
We investigated the feasibility of a combination therapy comprising fasudil, a Rho-kinase inhibitor, and DETA NONOate (diethylenetriamine NONOate, DN), a long acting nitric oxide donorboth loaded in liposomes modified with a homing peptide, CAR (CARSKNKDC)in the treatment of pulmonary arterial hypertension (PAH). We first prepared and characterized unmodified- and CAR-modified-liposomes of fasudil and DN. Using individual drugs alone or a mixture of fasudil and DN as controls, we studied the efficacy of the two liposomal preparations in reducing mean pulmonary arterial pressure (mPAP) in monocrotaline (MCT) and SUGEN-hypoxia induced PAH rats...
March 12, 2018: Molecular Pharmaceutics
D Kylhammar, R Hesselstrand, S Nielsen, C Scheele, G Rådegran
OBJECTIVE: To identify circulating angiogenic and inflammatory biomarkers with potential in screening for pulmonary arterial hypertension (PAH) in systemic sclerosis (SSc), and in early diagnosis and determination of treatment response in PAH. METHOD: Plasma samples were taken at the time of PAH diagnosis and at treatment follow-up after a median (interquartile range) of 4 months (3-9.8 months) in idiopathic (n = 9) and SSc-associated PAH (n = 11). In patients with SSc-associated PAH, plasma samples had also been gathered a median of 2 years (0...
March 12, 2018: Scandinavian Journal of Rheumatology
Orçun Çiftci, Neslihan Arzu Akgün, Kerem Can Yılmaz, Emir Karaçağlar, Alp Aydınalp, Atilla Sezgin, I Haldun Müderrisoğlu, Mehmet Haberal
OBJECTIVES: Endomyocardial biopsy sampling is used to check acute rejection after cardiac transplant. However, it may lead to tricuspid valve injury and cardiac perforation; therefore, less invasive tools may be useful. Right heart catheterization provides valuable information about cardiac hemodynamics. Herein, we aimed to determine the correlation of right heart catheterization parameters with acute rejection and death during cardiac transplant follow-up. MATERIALS AND METHODS: We retrospectively evaluated follow-up right heart catheterization and endomyocardial biopsy results from 47 adult patients who underwent cardiac transplant at Başkent University Faculty of Medicine between 2004 and 2016...
March 2018: Experimental and Clinical Transplantation
Jingwen Xia, Li Yang, Liang Dong, Mengjie Niu, Shengli Zhang, Zhiwei Yang, Gulinuer Wumaier, Ying Li, Xiaomin Wei, Yi Gong, Ning Zhu, Shengqing Li
Prostacyclin receptor (IP) and peroxisome proliferator-activated receptor-gamma (PPARγ) are both potential targets for treatment of pulmonary arterial hypertension (PAH). Expression of IP and PPARγ decreases in PAH, suggesting that screening of dual agonists of IP and PPARγ might be an efficient method for drug discovery. Virtual screening (VS) of potential IP-PPARγ dual-targeting agonists was performed in the ZINC database. Ten of the identified compounds were further screened, and cefminox was found to dramatically inhibit growth of PASMCs with no obvious cytotoxicity...
2018: Frontiers in Pharmacology
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