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David M Turer, Kelly L Koch, Todd M Koelling, Audrey H Wu, Francis D Pagani, Jonathan W Haft
Centrifugal and axial flow left ventricular assist devices have different hydrodynamic properties that may impact the effectiveness of left ventricular unloading. We sought to determine if patients implanted with the HeartWare HVAD (HW) and HeartMate II (HMII) had a similar degree of hemodynamic support by comparing parameters measured using echocardiography and right heart catheterization. Using our prospectively collected database, we identified 268 patients implanted with the HMII and 93 with the HW. Demographic characteristics were similar between groups...
July 26, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Suma P Goudar, G Hamilton Baker, Shahryar M Chowdhury, Kimberly J Reid, Girish Shirali, Mark A Scheurer
BACKGROUND: Adult studies demonstrate that echocardiographic measurements of cardiac function using speckle tracking correlate with invasive measurements, but such data in the pediatric population are sparse. Our aim was to compare speckle-derived measures of cardiac function to measurements routinely obtained by cardiac catheterization in children. METHODS: Echocardiograms were performed on the day of cardiac catheterization. Using Tomtec 2D Cardiac Performance Analysis, longitudinal strain (LS), longitudinal strain rate (LSR), early diastolic LSR, and ejection fraction (EF) for the right and left ventricle (RV and LV) were calculated via speckle tracking...
October 14, 2016: Echocardiography
Yossra Mahran, Robert Schueler, Marcel Weber, Carmen Pizarro, Georg Nickenig, Dirk Skowasch, Christoph Hammerstingl
AIM: To find parameters from transthorathic echocardiography (TTE) including speckle-tracking (ST) analysis of the right ventricle (RV) to identify precapillary pulmonary hypertension (PH). METHODS: Forty-four patients with suspected PH undergoing right heart catheterization (RHC) were consecutively included (mean age 63.1 ± 14 years, 61% male gender). All patients underwent standardized TTE including ST analysis of the RV. Based on the subsequent TTE-derived measurements, the presence of PH was assessed: Left ventricular ejection fraction (LVEF) was calculated by Simpsons rule from 4Ch...
August 26, 2016: World Journal of Cardiology
Tatsuyuki Osuga, Kensuke Nakamura, Tomoya Morita, Khoirun Nisa, Nozomu Yokoyama, Noboru Sasaki, Keitaro Morishita, Hiroshi Ohta, Mitsuyoshi Takiguchi
OBJECTIVE To elucidate the relationship between acute volume overload and left atrial phasic function in healthy dogs. ANIMALS 6 healthy Beagles. PROCEDURES Dogs were anesthetized. A Swan-Ganz catheter was placed to measure mean pulmonary capillary wedge pressure (PCWP). Cardiac preload was increased by IV infusion with lactated Ringer solution at 150 mL/kg/h for 90 minutes. Transthoracic echocardiography was performed before (baseline) and at 15, 30, 45, 60, 75, and 90 minutes after volume loading began. At each echocardiographic assessment point, apical 4-chamber images were recorded and analyzed to derive time-left atrial area curves...
September 2016: American Journal of Veterinary Research
Candelas Pérez Del Villar, Raquel Yotti, María Ángeles Espinosa, Enrique Gutiérrez-Ibañes, Alicia Barrio, María José Lorenzo, Pedro Luis Sánchez Fernández, Yolanda Benito, Raquel Prieto, Esther Pérez David, Pablo Martínez-Legazpi, Francisco Fernández-Avilés, Javier Bermejo
OBJECTIVES: The goal of this study was to determine the functional impact of paradoxical low-gradient aortic stenosis (PLGAS) and clarify whether the relevance of the valvular obstruction is related to baseline flow. BACKGROUND: Establishing the significance of PLGAS is particularly challenging. METHODS: Twenty symptomatic patients (77 ± 6 years of age; 17 female subjects) with PLGAS (mean gradient 28 ± 6 mm Hg; aortic valve area 0.8 ± 0...
August 20, 2016: JACC. Cardiovascular Imaging
Stéphane Doutreleau, Matthieu Canuet, Irina Enache, Paola Di Marco, Evelyne Lonsdorfer, Monique Oswald-Mammoser, Anne Charloux
BACKGROUND: Echocardiography (ECHO) plays a key role in both the diagnosis and prognosis of pulmonary hypertension (PH). Many equations have been published to assess right heart hemodynamics using ECHO. The objective of this study was to test the accuracy and precision of different echocardiographic equations in comparison with the right heart catheterization. METHODS AND RESULTS: Complete right heart hemodynamic assessments were prospectively obtained from 115 individuals (mean age 66±1 years; 57 males) who had known or suspected PH...
August 25, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Tony S Ma, David Paniagua, Ali E Denktas, Hani Jneid, Biswajit Kar, Wenyaw Chan, Biykem Bozkurt
In the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE) trial, use of a pulmonary artery catheter did not significantly affect advanced heart failure outcomes. However, the success of achieving the targeted hemodynamic goals of pulmonary capillary wedge pressure (PCWP) of 15 mm Hg and right atrial pressure (RAP) of 8 mm Hg and the association of these goals with clinical outcomes were not addressed. Furthermore, goals with 2 independent variables, PCWP and RAP, left room for uncertainties...
September 15, 2016: American Journal of Cardiology
E Wilson Grandin, Payman Zamani, Jeremy A Mazurek, Gregory S Troutman, Edo Y Birati, Esther Vorovich, Julio A Chirinos, Ryan J Tedford, Kenneth B Margulies, Pavan Atluri, J Eduardo Rame
BACKGROUND: Right ventricular (RV) adaptation to afterload is crucial for patients undergoing continuous-flow left ventricular assist device (cf-LVAD) implantation. We hypothesized that stratifying patients by RV pulsatile load, using pulmonary arterial compliance (PAC), and RV response to load, using the ratio of central venous to pulmonary capillary wedge pressure (CVP:PCWP), would identify patients at high risk for early right heart failure (RHF) and 6-month mortality after cf-LVAD...
June 24, 2016: Journal of Heart and Lung Transplantation
Barry A Borlaug, Vojtech Melenovsky, Katlyn E Koepp
RATIONALE: Abnormalities in nitric oxide signaling play a pivotal role in heart failure with preserved ejection fraction (HFpEF). Intravenous sodium nitrite, which is converted to nitric oxide in vivo, improves hemodynamics in HFpEF, but its use is limited by the need for parenteral administration. Nitrite can also be administered using a novel, portable micronebulizer system suitable for chronic use. OBJECTIVE: Determine whether inhaled nitrite improves hemodynamics in HFpEF...
September 16, 2016: Circulation Research
Hesham R Omar, Maya Guglin
INTRODUCTION: Results of studies that examined the value of B-type natriuretic peptide (BNP) reduction as a marker of decongestion have been inconsistent. We investigated whether longitudinal admission-to-discharge BNP reduction can be used to monitor decongestion during acute heart failure (HF). METHODS: We used the ESCAPE trial data to study the relationship between the magnitude of BNP reduction and various clinical and objective markers of decongestion. RESULTS: Admission-to-discharge reduction in BNP was recorded in 245 patients who were divided into tertiles (tertile 1 had BNP reduction<27pg/mL, tertile 2 had BNP reduction 27-334pg/mL and tertile 3 had BNP reduction>334pg/mL)...
October 15, 2016: International Journal of Cardiology
Scott J Denardo, David M Vock, Carsten M Schmalfuss, Gregory D Young, James E Tcheng, Christopher M O'Connor
BACKGROUND: Contrast media administered during cardiac catheterization can affect hemodynamic variables. However, little is documented about the effects of contrast on hemodynamics in heart failure patients or the prognostic value of baseline and changes in hemodynamics for predicting subsequent adverse events. METHODS AND RESULTS: In this prospective study of 150 heart failure patients, we measured hemodynamics at baseline and after administration of iodixanol or iopamidol contrast...
July 2016: Circulation. Heart Failure
Kathryn E Dean, Fay Lin, Polydoros N Kampaktsis, M Patricia George, Ashley Giambrone, Adrienne B Coya, Krishna Juluru
RATIONALE AND OBJECTIVES: We sought to determine if lung densities derived from computed tomography scans could be used to identify patients with pulmonary venous hypertension (Group II pulmonary hypertension [PH]), and to compare the performance of this metric with previously described metrics. MATERIALS AND METHODS: Patients were retrospectively included from a single-center cohort of patients with aortic stenosis being evaluated for transcatheter aortic valve replacement from April 2009 to July 2014...
August 2016: Academic Radiology
Rohan J Kalathiya, Brian A Houston, Jordan M Chaisson, Joshua C Grimm, Gerin R Stevens, Christopher M Sciortino, Ashish S Shah, Glenn J R Whitman, Stuart D Russell, Ryan J Tedford
To investigate longitudinal trends in valvular and ventricular function with long-term left ventricular assist device (LVAD) therapy, we analyzed hemodynamic and echocardiographic data of patients with at least 2 years of continuous LVAD support. All 130 patients who underwent HeartMate II implantation at our institution between 2005 and 2012 were reviewed. Twenty patients had hemodynamic and echocardiographic evaluations in both the early (0-6 months) and late (2-3 years) postoperative period. Patients on inotropic therapy or temporary mechanical support were excluded...
May 17, 2016: Artificial Organs
William M Oldham, Gregory D Lewis, Alexander R Opotowsky, Aaron B Waxman, David M Systrom
To determine whether low ventricular filling pressures are a clinically relevant etiology of unexplained dyspnea on exertion, a database of 619 consecutive, clinically indicated invasive cardiopulmonary exercise tests (iCPETs) was reviewed to identify patients with low maximum aerobic capacity (V̇o2max) due to inadequate peak cardiac output (Qtmax) with normal biventricular ejection fractions and without pulmonary hypertension (impaired: n = 49, V̇o2max = 53% predicted [interquartile range (IQR): 47%-64%], Qtmax = 72% predicted [62%-76%])...
March 2016: Pulmonary Circulation
Erik Tossavainen, Michael Y Henein, Christer Grönlund, Per Lindqvist
OBJECTIVES: We hypothesized that left atrial deformation during atrial systole (LASRa) correlates with pulmonary capillary wedge pressure (PCWP), thus enabling echo-derived pulmonary vascular resistance (PVR) estimation in a wide range of different subsets of patients. BACKGROUND: Various etiologies of pulmonary hypertension (PH) have different mechanisms and treatments for breathlessness. Irrespective of the location of the underlying pulmonary vascular pathology, pre- or postcapillary, the resulting PH is fairly easy to assess by Doppler echocardiography, but PVR remains a challenge...
August 2016: Echocardiography
Desabandhu Vinayakumar, Uppalakal Bijilesh, C G Sajeev, Gopalan Nair Rajesh, Cicy Bastion, P Kadermuneer, V Haridasan, Dolly Mathew, Biju George, M N Krishnan
AIMS: We sought to evaluate the correlation between PCWP and LAP and to compare transmitral gradients obtained with LAP and PCWP in MS, before and after balloon mitral valvotomy (BMV). METHODS: Consecutive patients with MS for BMV were included in this prospective cohort study. Simultaneous PCWP and LAP were recorded followed by simultaneous left atrium-left ventricular (LA-LV) and pulmonary capillary wedge pressure-left ventricular (PCWP-LV) gradients before and after BMV...
March 2016: Indian Heart Journal
Francesco Corradi, Claudia Brusasco, Antonella Vezzani, Gregorio Santori, Tullio Manca, Lorenzo Ball, Francesco Nicolini, Tiziano Gherli, Vito Brusasco
BACKGROUND: Lung ultrasonography (LUS) has been used for noninvasive detection of pulmonary edema. Semiquantitative LUS visual scores (visual LUS [V-LUS]) based on B lines are moderately correlated with pulmonary capillary wedge pressure (PCWP) and extravascular lung water (EVLW). A new computer-aided quantitative LUS (Q-LUS) analysis has been recently proposed. This study investigated whether Q-LUS better correlates with PCWP and EVLW than V-LUS and to what extent positive end-expiratory pressure (PEEP) affects the assessment of pulmonary edema by Q-LUS or V-LUS...
September 2016: Chest
Gregory M Scalia, Isabel G Scalia, Rebecca Kierle, Rebekka Beaumont, David B Cross, John Feenstra, Darryl J Burstow, Benjamin T Fitzgerald, David G Platts
BACKGROUND: Right heart catheterisation is the gold-standard for differentiating pre-capillary pulmonary hypertension (high mean pulmonary artery pressure, normal pulmonary wedge pressure) from post-capillary physiology (elevated pulmonary wedge pressure). The new non-invasive parameter, ePLAR (echocardiographic Pulmonary to Left Atrial Ratio) is calculated from the maximum tricuspid regurgitation continuous wave Doppler velocity (m/s) divided by the transmitral E-wave:septal mitral annular Doppler Tissue Imaging e'-wave ratio (TRVmax/E:e')...
June 1, 2016: International Journal of Cardiology
D Y Wu, W X Huang, J Chen, D J Xue, J J Zhou, X M Lu
OBJECTIVE: To explore the effects of different fluid resuscitation regimens on oxygen metabolism during shock stage of burn injury in swine. METHODS: Twelve Bama miniature swines were divided into crystal and colloid group (Group 1) and Parkland group (Group 2) according to the random number table. The swine models of burns shock were established. The fluid resuscitation was begun at post injury hour (PIH) 2 according to Chinese formulation or Parkland's formulation, respectively...
March 29, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Tetsuro Yokokawa, Yasuo Sugano, Akito Shimouchi, Atsushi Shibata, Naoya Jinno, Toshiyuki Nagai, Hideaki Kanzaki, Takeshi Aiba, Kengo Kusano, Mikiyasu Shirai, Yasuchika Takeishi, Satoshi Yasuda, Hisao Ogawa, Toshihisa Anzai
BACKGROUND: We hypothesized that exhaled acetone concentration (EAC), reflecting altered blood ketone body metabolism and increased acetone exhaust because of pulmonary congestion in heart failure (HF), would correlate with hemodynamic parameters in patients with non-ischemic chronic HF. METHODS AND RESULTS: We prospectively enrolled 102 non-ischemic HF patients with New York Heart Association (NYHA) class I-III. Exhaled breath was collected after an overnight fast...
April 25, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
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