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https://www.readbyqxmd.com/read/29147768/non-invasive-methods-for-estimating-mpap-in-copd-using-cardiovascular-magnetic-resonance-imaging
#1
C S Johns, S Rajaram, D A Capener, C Oram, C Elliot, R Condliffe, D G Kiely, J M Wild, A J Swift
PURPOSE: Pulmonary hypertension (PH) is associated with a poor outcome in chronic obstructive pulmonary disease (COPD) and is diagnosed invasively. We aimed to assess the diagnostic accuracy and prognostic value of non-invasive cardiovascular magnetic resonance (CMR) models. METHODS: Patients with COPD and suspected PH, who underwent CMR and right heart catheter (RHC) were identified. Three candidate models were assessed: 1, CMR-RV model, based on right ventricular (RV) mass and interventricular septal angle; 2, CMR PA/RV includes RV mass, septal angle and pulmonary artery (PA) measurements; 3, the Alpha index, based on RV ejection fraction and PA size...
November 16, 2017: European Radiology
https://www.readbyqxmd.com/read/29147168/study-of-the-characteristics-of-pulmonary-trunk-in-pulmonary-hypertension-secondary-to-left-heart-disease-using-pressure-velocity-loops-pu-loops
#2
Shizuo Hanya, Kengo Yoshii, Motoaki Sugawara
Objectives: Although pulmonary hypertension (PH) caused by left heart disease (PH-LHD) is more common in PH, little is known about its properties of pulmonary artery (PA) in PH-LHD. The purpose of this study was to measure pulmonary regional pulse wave velocity (PWV) and to quantify the magnitude of reflected waves in patients with PH-LHD by the analysis of the pressure-velocity loops (PU-loop). Methods: High-fidelity PA pressure (Pm) and PA velocity (Vm) were measured in 11 subjects with PH-LHD (mean Pm>25 mmHg), 1 subject with atrial septal defect (ASD) without PH and 12 control subjects, using multisensor catheters...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29146614/heart-rate-reduction-improves-biventricular-function-and-interactions-in-experimental-pulmonary-hypertension
#3
Olga Gomez, Kenichi Okumura, Osami Honjo, Mei Sun, Ryo Ishii, Bart Bijens, Mark K Friedberg
OBJECTIVES: To investigate mechanisms of heart rate (HR) reduction on biventricular function and interactions in experimental pulmonary arterial hypertension (PAH). METHODS: We compared cardiac-cycle mechanics and interventricular interactions in 15 sham, 8 monocrotaline-PAH, 9 PAH+carvedilol and 8 PAH+ivabradine rats. We used echocardiography to assess biventricular function, timing of cardiac- cycle events and septal position in PAH rats; and related HR reduction effect on biventricular function measured by echocardiography and conductance catheter...
November 16, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29145311/pulmonary-hypertension-as-a-manifestation-of-mitochondrial-disease-a-case-report-and-review-of-the-literature
#4
Shan Xu, Xiaoling Xu, Jisong Zhang, Kejing Ying, Yuquan Shao, Ruifeng Zhang
BACKGROUND: Mitochondrial diseases are a group of multisystem heterogeneous diseases caused by pathologic dysfunction of the mitochondrial respiratory chain. A wide range of clinical expression has been described. However, pulmonary hypertension has rarely been described in association with mitochondrial disease until the past decade, and there is no currently recognized treatment for the pulmonary hypertension complicated with mitochondrial disorder. PATIENT CONCERNS: We reported the case of a 15-year-old boy who presented with shortness of breath and exercise limitation after a cold, and the diagnosis of pulmonary hypertension was confirmed by right heart catheter...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29141527/decreases-in-mixed-venous-blood-o2-saturation-in-cardiac-surgery-patients-following-extubation
#5
Jeffrey Williams, Anna McLean, Jalil Ahari, Arun Jose, Georges Al-Helou, Italo Ibi, Farzad Najam Md, Guillermo Gutierrez
BACKGROUND: Decreases in mixed venous O2 saturation (SvO2) have been reported to occur in postcardiac surgery patients during weaning from mechanical ventilation. Our aim was to establish whether the physiological mechanism responsible for this phenomenon was a decrease in systemic O2 delivery (DO2) or an increase in global O2 consumption ([Formula: see text]O2). METHODS: We studied 21 mechanically ventilated, postoperative cardiac patients for 30 minutes before and 60 minutes after extubation...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29137910/tamponade-hemodynamic-and-echocardiographic-diagnosis
#6
REVIEW
Mark J Kearns, Keith R Walley
Cardiac tamponade is a medical emergency that can be readily reversed with timely recognition and appropriate intervention. The clinical diagnosis of cardiac tamponade requires synthesis of a constellation of otherwise non-specific features, based on an understanding of the underlying pathophysiology. Whereas echocardiographic examination is a central component of diagnosis, alone it is insufficient to establish the physiologic diagnosis of hemodynamically significant cardiac tamponade. The hemodynamic diagnosis of cardiac tamponade requires clinical evidence of low cardiac output and stroke volume in the setting of elevated cardiac filling pressures, with evidence of increased sympathetic tone (tachycardia, peripheral vasoconstriction, etc), and exclusion of other causes of shock as the primary problem (particularly cardiogenic shock)...
November 11, 2017: Chest
https://www.readbyqxmd.com/read/29135479/use-of-remote-pulmonary-artery-pressure-monitoring-cardiomems-system-in-total-artificial-heart-to-assess-pulmonary-hemodynamics-for-heart-transplantation
#7
Salman Gohar, Ziad Taimeh, Jeff Morgan, O H Frazier, Francisco Arabia, Andrew Civitello, Ajith Nair
The temporary total artificial heart (TAH-t) has been valuable as a bridge to transplantation in patients with biventricular failure. However, the challenges of accurately assessing pulmonary vascular resistance after TAH-t implantation can preclude these patients from heart transplantation, especially those with pre-existing pulmonary hypertension. The CardioMEMS Heart Failure System (St. Jude's Medical, Little Canada, MN) comprises a wireless pressure sensor that is implanted percutaneously in the pulmonary artery and transmits real-time measurements of pulmonary artery pressures...
November 8, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29130036/accuracy-precision-and-trending-ability-of-electrical-cardiometry-cardiac-index-versus-continuous-pulmonary-artery-thermodilution-method-a-prospective-observational-study
#8
P B W Cox, A M den Ouden, M Theunissen, L J Montenij, A G H Kessels, M D Lancé, W F F A Buhre, M A E Marcus
Introduction: Evaluation of accuracy, precision, and trending ability of cardiac index (CI) measurements using the Aesculon™ bioimpedance electrical cardiometry (Aesc) compared to the continuous pulmonary artery thermodilution catheter (PAC) technique before, during, and after cardiac surgery. Methods: A prospective observational study with fifty patients with ASA 3-4. At six time points (T), measurements of CI simultaneously by continuous cardiac output pulmonary thermodilution and thoracic bioimpedance and standard hemodynamics were performed...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29128608/a-retrospective-comparison-of-survivors-and-non-survivors-of-massive-pulmonary-embolism-receiving-veno-arterial-extracorporeal-membrane-oxygenation-support
#9
Bennet George, Marc Parazino, Hesham R Omar, George Davis, Maya Guglin, John Gurley, Susan Smyth
INTRODUCTION: While the optimal care of patients with massive pulmonary embolism (PE) is unclear, the general goal of therapy is to rapidly correct the physiologic derangements propagated by obstructive clot. Extracorporeal membrane oxygenation (ECMO) in this setting is promising, however the paucity of data limits its routine use. Our institution expanded the role of ECMO as an advanced therapy option in the initial management of massive PE. The purpose of this project was to evaluate ECMO-treated patients with massive PE at an academic medical center and report shortterm mortality outcomes...
November 8, 2017: Resuscitation
https://www.readbyqxmd.com/read/29124006/selective-pulmonary-artery-occlusion-to-treat-hemoptysis-associated-with-pulmonary-venous-obstruction
#10
Melissa S W Yamauchi, Mary Hunt Martin, Harlan R Muntz, Ronald W Day
Hemoptysis may occur in patients with pulmonary venous obstruction and prominent decompressing vessels in the airways adjacent to the affected pulmonary veins. The options for treatment of hemoptysis are limited, particularly when efforts to alleviate pulmonary venous obstruction have failed. Here we describe a patient with hemoptysis associated with stenosis of the central left upper pulmonary vein and occlusion of the central left lower pulmonary vein. The left upper pulmonary vein was dilated with balloon catheters and a vascular plug was placed in the left lower pulmonary artery...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29119549/a-prototype-small-bore-ventilation-catheter-with-a-cuff-cuff-inflation-optimizes-ventilation-with-the-ventrain
#11
M W P de Wolf, T van der Beek, A E Hamaekers, M Theunissen, D Enk
BACKGROUND: Ventilation through small-diameter tubes typically precludes use of a cuff as this will impede the necessary passive outflow of gas alongside the tube's outer surface. Ventrain assists expiration and enables oxygenation and normoventilation through small-bore cannulas or catheters, particularly in obstructed airways. A small-bore ventilation catheter (SBVC; 40 cm long, 2.2 mm inner diameter) with a separate pressure monitoring lumen and a cuff was developed. Efficacy of oxygenation and ventilation with Ventrain through this catheter was investigated in sealed and open airways in a porcine cross-over study...
November 8, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29115016/pulmonary-hypertension-in-stiff-left-atrial-syndrome-pathogenesis-and-treatment-in-one
#12
Micha T Maeder, Reto Nägele, Philipp Rohner, Daniel Weilenmann
We present the rare case of a patient with pulmonary hypertension in the context of the stiff left atrial syndrome after extensive catheter ablation, a unique constellation characterized by high pulmonary artery and pulmonary artery wedge pressures due to left atrial dysfunction but normal left ventricular end-diastolic pressure, normal mitral valve, and absence pulmonary vein stenosis. This patient was surprisingly oligosymptomatic, however, which may have been due to a persistent post-puncture atrial septal defect, which may have allowed for controlled left atrial decompression, which is in line with the novel concept of the catheter-based creation of an intracardiac shunt as a treatment for heart failure...
November 8, 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29109853/mesenteric-vein-thrombosis-following-impregnation-via-in-vitro-fertilization-embryo-transfer
#13
Masaaki Hirata, Hiroko Yano, Tomoe Taji, Yoshiharu Shirakata
Pregnancy is an acquired hypercoagulable state. Most patients with thrombosis that develops during pregnancy present with deep vein leg thrombosis and/or pulmonary embolism, whereas the development of mesenteric vein thrombosis (MVT) in pregnant patients is rare. We report a case of MVT in a 34-year-old woman who had achieved pregnancy via in vitro fertilization-embryo transfer (IVF-ET). At 7 wk of gestation, the patient was referred to us due to abdominal pain accompanied by vomiting and hematochezia, and she was diagnosed with superior MVT...
October 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29089339/wave-intensity-analysis-provides-novel-insights-into-pulmonary-arterial-hypertension-and-chronic-thromboembolic-pulmonary-hypertension
#14
Junjing Su, Charlotte Manisty, Kim H Parker, Ulf Simonsen, Jens Erik Nielsen-Kudsk, Soren Mellemkjaer, Susan Connolly, P Boon Lim, Zachary I Whinnett, Iqbal S Malik, Geoffrey Watson, Justin E Davies, Simon Gibbs, Alun D Hughes, Luke Howard
BACKGROUND: In contrast to systemic hypertension, the significance of arterial waves in pulmonary hypertension (PH) is not well understood. We hypothesized that arterial wave energy and wave reflection are augmented in PH and that wave behavior differs between patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). METHODS AND RESULTS: Right heart catheterization was performed using a pressure and Doppler flow sensor-tipped catheter to obtain simultaneous pressure and flow velocity measurements in the pulmonary artery...
October 31, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29076367/maternal-and-fetal-effects-of-dexmedetomidine-infusion-in-pregnant-ewes-anesthetized-with-sevoflurane
#15
Mauricio Loría Lépiz, Rebecca Sayre, Onkar Sawant, James Barr, Medora Pashmakova, Kevin Washburn, Shannon Washburn
OBJECTIVE To characterize the maternal and fetal cardiopulmonary effects of a low-dose infusion of dexmedetomidine without a loading dose in pregnant ewes anesthetized with sevoflurane. ANIMALS 11 pregnant ewes. PROCEDURES Anesthesia was induced with propofol and maintained with sevoflurane. Ewes and fetuses were instrumented with arterial and venous catheters, and thermodilution-pulmonary arterial catheters were placed in the ewes. Baseline measurements were obtained at an end-tidal sevoflurane concentration of 3...
November 2017: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/29073366/catheter-directed-thrombolysis-for-intermediate-risk-pulmonary-embolism
#16
David Furfaro, R Scott Stephens, Michael B Streiff, Roy Brower
Intermediate risk pulmonary embolism is common and carries a risk of progression to hemodynamic collapse and death. Catheter directed thrombolysis is an increasingly utilized treatment option, based largely on the assumptions that it is more efficacious than anticoagulation alone, and safer than systemic thrombolysis. In this review, we critically analyze the published data regarding catheter directed thrombolysis for the treatment of intermediate risk pulmonary embolism. Catheter directed thrombolysis reduces right heart strain and lowers pulmonary artery pressures more quickly than anticoagulation alone...
October 26, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29069014/decreased-haptoglobin-levels-inversely-correlated-with-pulmonary-artery-pressure-in-patients-with-pulmonary-arterial-hypertension-a-cross-sectional-study
#17
Hiroyuki Nakamura, Masaru Kato, Toshitaka Nakaya, Michihiro Kono, Shun Tanimura, Takahiro Sato, Yuichiro Fujieda, Kenji Oku, Hiroshi Ohira, Toshiyuki Bohgaki, Shinsuke Yasuda, Ichizo Tsujino, Masaharu Nishimura, Tatsuya Atsumi
We investigated the serum haptoglobin levels in patients with pulmonary arterial hypertension (PAH) based on the hypothesis that haptoglobin levels would reflect subclinical hemolysis due to microangiopathy in pulmonary arterioles.This cross-sectional study included 3 groups of patients attending Hokkaido University Hospital: PAH, chronic thromboembolic pulmonary hypertension (CTEPH), and connective tissue diseases (CTD) without PAH (CTD-non-PAH) group. Serum haptoglobin levels were measured by standardized turbidimetric immunoassay in all patients...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29059883/monitoring-of-cardiac-output-and-lung-ventilation-by-electrical-impedance-tomography-in-a-porcine-model-of-acute-lung-injury
#18
Nadine Hochhausen, Henriette Dohmeier, Rolf Rossaint, Michael Czaplik
Adequate medical treatment of the Acute Respiratory Distress Syndrome is still challenging since patient-individual aspects have to be taken into account. Lung protective ventilation and hemodynamic stability have always been two of the most crucial aims of intensive care therapy. For both aspects, a continuous - preferably non-invasive - monitoring is desirable that is available at the bedside. Unfortunately, there is no technique clinically established yet, that provides both measurement of cardiac stroke volume and ventilation dynamics in real-time...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29058996/successful-use-of-extracorporeal-membrane-oxygenation-in-a-child-with-obstructive-shock-due-to-massive-bilateral-pulmonary-embolism
#19
Aditya Badheka, Pradeep Bangalore Prakash, Veerajalandhar Allareddy
BACKGROUND: Acute massive pulmonary embolism (PE) is a very rare condition in children. We report the successful use of veno-arterial extracorporeal membrane oxygenation (VA ECMO) as a lifesaving modality in a child with acute massive PE. CASE PRESENTATION: A nine-year-old female with spinal muscular atrophy type 1, chronic respiratory failure with tracheostomy and ventilator dependence presented with tachypnea and hypoxia. She had recent coiling of her pulmonary arterio-venous malformation...
October 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29054842/acute-biventricular-mechanical-circulatory-support-for-cardiogenic-shock
#20
Sudeep Kuchibhotla, Michele L Esposito, Catalina Breton, Robert Pedicini, Andrew Mullin, Ryan O'Kelly, Mark Anderson, Dennis L Morris, George Batsides, Danny Ramzy, Mark Grise, Duc Thinh Pham, Navin K Kapur
BACKGROUND: Biventricular failure is associated with high in-hospital mortality. Limited data regarding the efficacy of biventricular Impella axial flow catheters (BiPella) support for biventricular failure exist. The aim of this study was to explore the clinical utility of percutaneously delivered BiPella as a novel acute mechanical support strategy for patients with cardiogenic shock complicated by biventricular failure. METHODS AND RESULTS: We retrospectively analyzed data from 20 patients receiving BiPella for biventricular failure from 5 tertiary-care hospitals in the United States...
October 20, 2017: Journal of the American Heart Association
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