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Pulmonary vascular resistance

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https://www.readbyqxmd.com/read/27925228/a-mock-circulatory-system-incorporating-a-compliant-3d-printed-anatomical-model-to-investigate-pulmonary-hemodynamics
#1
Paul G M Knoops, Giovanni Biglino, Alun D Hughes, Kim H Parker, Linzhang Xu, Silvia Schievano, Ryo Torii
A realistic mock circulatory system (MCS) could be a valuable in vitro testbed to study human circulatory hemodynamics. The objective of this study was to design a MCS replicating the pulmonary arterial circulation, incorporating an anatomically representative arterial model suitable for testing clinically relevant scenarios. A second objective of the study was to ensure the system's compatibility with magnetic resonance imaging (MRI) for additional measurements. A latex pulmonary arterial model with two generations of bifurcations was manufactured starting from a 3D-printed mold reconstructed from patient data...
December 7, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27922752/abnormal-glucose-metabolism-and-high-energy-expenditure-in-idiopathic-pulmonary-arterial-hypertension
#2
Gustavo A Heresi, Steven K Malin, Jarrod W Barnes, Liping Tian, John P Kirwan, Raed A Dweik
RATIONALE: Insulin resistance has emerged as a potential mechanism related to the pathogenesis of idiopathic pulmonary arterial hypertension (IPAH). However, direct measurements of insulin and glucose metabolism have not been performed in IPAH patients to date. OBJECTIVES: To perform comprehensive metabolic phenotyping on humans with IPAH. METHODS: We assessed plasma insulin and glucose using an oral glucose tolerance test and estimated insulin resistance and beta-cell function in 14 IPAH patients and 14 controls matched for age, sex, blood pressure, and body mass index (BMI),...
December 6, 2016: Annals of the American Thoracic Society
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
#3
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/27913006/noninvasive-prediction-of-pulmonary-artery-pressure-and-vascular-resistance-by-using-cardiac-magnetic-resonance-indices
#4
Zhang Zhang, Meng Wang, Zhenwen Yang, Fan Yang, Dong Li, Tielian Yu, Ningnannan Zhang
BACKGROUND: Cardiac magnetic resonance (CMR) has promise of being able to provide frequent cardiac morphology and function evaluations noninvasively for repeated follow-ups of pulmonary arterial hypertension (PAH) patients after the initial right heart catheterization (RHC) diagnosis. By using the noninvasive CMR indices, the present study aimed to formulate and validate a prediction model of mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (PVR). METHODS: Both Derivation Cohort (N=25) and Validation Cohort (N=25) of PAH patients underwent CMR and RHC within one week...
October 29, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27912199/right-ventricular-dyssynchrony-predicts-clinical-outcomes-in-patients-with-pulmonary-hypertension
#5
Mitsushige Murata, Toshimitsu Tsugu, Takashi Kawakami, Masaharu Kataoka, Yugo Minakata, Jin Endo, Hikaru Tsuruta, Yuji Itabashi, Yuichiro Maekawa, Keiichi Fukuda
BACKGROUND: RV dyssynchrony has been described in patients with pulmonary hypertension (PH) and is an independent predictor of clinical worsening; however, the optimal method for measuring RV dyssynchrony has not been fully established. This study aimed to investigate whether RV dyssynchrony is correlated with hemodynamics and prognosis in PH patients and to identify the best parameter for evaluating RV dyssynchrony. METHODS: This study assessed 100 PH patients, measuring mean pulmonary artery pressure (mPAP), pulmonary vascular resistance (PVR), and cardiac index (CI) by right heart catheterization (RHC)...
November 14, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27893646/acute-right-heart-failure-after-hemorrhagic-shock-and-trauma-pneumonectomy-a-management-approach-a-blinded-randomized-controlled-animal-trial-using-inhaled-nitric-oxide
#6
Andrea L Lubitz, Lars O Sjoholm, Amy Goldberg, Abhijit Pathak, Thomas Santora, Thomas E Sharp, Markus Wallner, Remus M Berretta, Lauren A Poole, Jichuan Wu, Marla R Wolfson
BACKGROUND: Hemorrhagic shock and pneumonectomy causes an acute increase in pulmonary vascular resistance (PVR). The increase in PVR and right ventricular (RV) afterload leads to acute RV failure, thus reducing left ventricular (LV) preload and output. iNO lowers PVR by relaxing pulmonary arterial smooth muscle without remarkable systemic vascular effects. We hypothesized that with hemorrhagic shock and pneumonectomy, iNO can be used to decrease PVR and mitigate right heart failure. METHODS: A hemorrhagic shock and pneumonectomy model was developed using sheep...
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27893420/prognostic-value-of-three-dimensional-echocardiographic-right-ventricular-ejection-fraction-in-patients-with-pulmonary-arterial-hypertension
#7
Mitsushige Murata, Toshimitsu Tsugu, Takashi Kawakami, Masaharu Kataoka, Yugo Minakata, Jin Endo, Hikaru Tsuruta, Yuji Itabashi, Yuichiro Maekawa, Mitsuru Murata, Keiichi Fukuda
BACKGROUND: Right ventricular (RV) function is an independent predictor of clinical outcomes in patients with pulmonary arterial hypertension (PAH). However, it remains controversial which RV parameter should be measured as an appropriate index for the treatment of PAH. The aim of this study was to identify the most useful parameter that correlates with hemodynamics and predicts clinical outcomes in PAH. RESULTS: Most of the clinical and echocardiographic RV parameters were significantly correlated with pulmonary vascular resistance (PVR) as well as mean pulmonary arterial pressure (mPAP)...
November 22, 2016: Oncotarget
https://www.readbyqxmd.com/read/27890630/arteriovenous-renal-replacement-therapy-in-end-stage-left-sided-heart-failure-patients-has-detrimental-effect-on-patients-with-impaired-right-ventricular-function
#8
Evangelos Repasos, Elisabeth Kaldara, Christos Pantsios, Chris Kapelios, Emmeleia Nana, Spiridon Vernadakis, Christina Melexopoulou, Konstantinos Malliaras, John Boletis, John N Nanas
INTRODUCTION: Chronic intermittent renal replacement therapy(RRT) is an alternate method of decongestion for patients presenting with diuretic-resistant, end-stage heart failure(HF) and cardiorenal syndrome. The optimal method of vascular access has not been confirmed. This study compared the 6-month outcomes of patients with end-stage HF after the creation of arteriovenous communications (AVC) versus other means of RRT. METHODS: We treated 40 patients with chronic, intermittent, ambulatory RRT, of whom 15 (37...
November 23, 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/27887774/rationale-and-study-design-of-respite-an-open-label-phase-3b-study-of-riociguat-in-patients-with-pulmonary-arterial-hypertension-who-demonstrate-an-insufficient-response-to-treatment-with-phosphodiesterase-5-inhibitors
#9
Marius M Hoeper, James R Klinger, Raymond L Benza, Gerald Simonneau, David Langleben, Robert Naeije, Paul A Corris
Patients with pulmonary arterial hypertension (PAH) who do not have an adequate response to therapy with phosphodiesterase-5 inhibitors (PDE-5i) may have insufficient synthesis of cyclic guanosine monophosphate (cGMP). These patients may respond to a direct soluble guanylate cyclase (sGC) stimulator such as riociguat. RESPITE (NCT02007629) was an open-label, multicenter, uncontrolled, single-arm phase 3b study of riociguat in patients with PAH who demonstrated an insufficient response to treatment with PDE-5i...
November 5, 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27884766/mechanisms-of-vascular-dysfunction-in-copd-and-effects-of-a-novel-soluble-epoxide-hydrolase-inhibitor-in-smokers
#10
Lucy Yang, Joseph Cheriyan, David D Gutterman, Ruth J Mayer, Zsuzsanna Ament, Jules L Griffin, Aili L Lazaar, David E Newby, Ruth Tal-Singer, Ian B Wilkinson
BACKGROUND: Smoking and chronic obstructive pulmonary disease (COPD) are risk factors for cardiovascular disease, and the pathogenesis may involve endothelial dysfunction. We tested the hypothesis that endothelium-derived epoxyeicosatrienoic acid (EET)-mediated endothelial function is impaired in patients with COPD, and a novel sEH inhibitor GSK2256294 attenuates EET-mediated endothelial dysfunction in human resistance vessels both in vitro and in vivo. METHODS: Endogenous and stimulated endothelial release of EETs was assessed in 12 COPD patients, 11 overweight smokers, and 2 matched control groups, using forearm plethysmography with intra-arterial infusions of fluconazole, bradykinin, and the combination...
November 21, 2016: Chest
https://www.readbyqxmd.com/read/27878206/new-findings-on-venous-thrombogenesis
#11
James R Byrnes, Alisa S Wolberg
Venous thrombosis (VT) is the third most common cause of cardiovascular death worldwide. Complications from VT and pulmonary embolism are the leading cause of lost disability-adjusted life years. Risks include genetic (e.g., non-O blood group, activated protein C resistance, hyperprothrombinemia) and acquired (e.g., age, surgery, cancer, pregnancy, immobilisation, female hormone use) factors. Pathophysiologic mechanisms that promote VT are incompletely understood, but involve abnormalities in blood coagulability, vessel function, and flow (so-called Virchow's Triad)...
November 23, 2016: Hämostaseologie
https://www.readbyqxmd.com/read/27875533/pulmonary-arterial-capacitance-predicts-cardiac-events-in-pulmonary-hypertension-due-to-left-heart-disease
#12
Koichi Sugimoto, Akiomi Yoshihisa, Kazuhiko Nakazato, Yuichiro Jin, Satoshi Suzuki, Tetsuro Yokokawa, Tomofumi Misaka, Takayoshi Yamaki, Hiroyuki Kunii, Hitoshi Suzuki, Shu-Ichi Saitoh, Yasuchika Takeishi
BACKGROUND: Although pulmonary hypertension due to left heart disease (LHD-PH) accounts for the largest proportion of pulmonary hypertension, few reports on the epidemiological analysis of LHD-PH exist. Recently, pulmonary arterial capacitance (PAC) has attracted attention as a possible factor of right ventricular afterload along with pulmonary vascular resistance. We therefore investigated the clinical significance of PAC in LHD-PH. METHODS: The subject consisted of 252 LHD-PH patients (145 men, mean age 63...
2016: PloS One
https://www.readbyqxmd.com/read/27873373/cardiac-output-and-blood-flow-redistribution-in-the-fetus-with-d-loop-transposition-of-the-great-arteries-and-intact-ventricular-septum-insights-into-the-pathophysiology
#13
Max E Godfrey, Kevin G Friedman, Monika Drogosz, Abraham M Rudolph, Wayne Tworetzky
OBJECTIVES: Although the postnatal physiology of D-loop transposition of the great arteries with intact ventricular septum (DTGA-IVS) is well established, little is known about fetal DTGA-IVS. In the normal fetus, the pulmonary valve (PV) is larger than the aortic valve (AoV), there is exclusive right to left flow at the foramen ovale (FO) and ductus arteriosus (DA), and the left ventricle (LV) ejects 40% of combined ventricular output (CVO) through the aorta, primarily to the brain. In DTGA-IVS, the LV ejects O2 -rich blood to the pulmonary artery, theoretically leading to pulmonary vasodilation, increased branch pulmonary arterial flow and reduced DA flow...
November 22, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27873231/atherosclerotic-renal-artery-stenosis
#14
Robert Schoepe, Stephen McQuillan, Debbie Valsan, Geoffrey Teehan
Atherosclerotic Renal Artery Stenosis is a form or peripheral arterial disease that tends to affect older subjects with hyperlipidemia, history of tobacco use, and who have other coexistent forms of vascular insufficiency. An abdominal bruit on physical exam can be a helpful clue. Slowly progressive, it can lead to critical narrowing of the renal arteries which creates a cascade of events such as renin-angiotensin-aldosterone activation (RAAS), hypertension, acute pulmonary edema, and renal fibrosis. The hypertension is considered a secondary form and can even be resistant to multiple antihypertensives...
November 22, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27867361/calcium-sensing-receptor-regulates-cytosolic-ca-2-and-plays-a-major-role-in-the-development-of-pulmonary-hypertension
#15
REVIEW
Kimberly A Smith, Ramon J Ayon, Haiyang Tang, Ayako Makino, Jason X-J Yuan
Pulmonary arterial hypertension (PAH) is a progressive disease characterized by elevated pulmonary vascular resistance (PVR) leading to right heart failure and premature death. The increased PVR results in part from pulmonary vascular remodeling and sustained pulmonary vasoconstriction. Excessive pulmonary vascular remodeling stems from increased pulmonary arterial smooth muscle cell (PASMC) proliferation and decreased PASMC apoptosis. A rise in cytosolic free Ca(2+) concentration ([Ca(2+)]cyt) in PASMC is a major trigger for pulmonary vasoconstriction and a key stimulus for PASMC proliferation and migration, both contributing to the development of pulmonary vascular remodeling...
2016: Frontiers in Physiology
https://www.readbyqxmd.com/read/27866929/long-term-outcomes-of-pulmonary-arterial-hypertension-under-specific-drug-therapy-in-eisenmenger-syndrome
#16
Sébastien Hascoët, Alban-Elouen Baruteau, Marc Humbert, Gérald Simonneau, Xavier Jais, Jérôme Petit, Daniela Laux, Olivier Sitbon, Virginie Lambert, André Capderou
BACKGROUND: The long-term effectiveness of pulmonary arterial hypertension-specific drug therapy (PAH-SDT) in Eisenmenger syndrome is controversial. We investigated short-term and long-term hemodynamic changes under PAH-SDT and their associations with outcomes in a bicentric cohort. METHODS: Over 20 years, we included 69 patients with congenital heart disease, an indexed pulmonary vascular resistance (PVRi) >8 WU·m(2), and 292 standardized catheterizations at baseline and after PAH-SDT initiation or intensification...
October 15, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27866432/maternal-cardiac-haemodynamics-in-severe-pre-eclampsia-complicated-by-acute-pulmonary-oedema-a-review
#17
I Bhorat, D P Naidoo, J Moodley
AIM: To establish alterations in maternal cardiac haemodynamics and function using electrocardiography and echocardiography in severe pre-eclampsia complicated by acute pulmonary oedema. METHODS: An extensive literature search including any research articles, randomised control trials, observational study, case report or expert or consensus statement pertaining to severe pre-eclampsia, eclampsia, hypertensive crises of pregnancy, pulmonary oedema, maternal cardiac haemodynamics, Holter monitoring and maternal echocardiography was done...
November 21, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27866021/early-pulmonary-arterial-hypertension-immediately-after-closure-of-a-ventricular-or-complete-atrioventricular-septal-defect-beyond-6months-of-age
#18
P Bambul Heck, A Eicken, J Kasnar-Samprec, P Ewert, A Hager
BACKGROUND: Pulmonary arterial hypertension (PAH) is virtually absent after closure of ventricular septal defect (VSD) in the first six months of life. However the prevalence of PAH in patients, who underwent VSD closure later, is not clear. The aim of this study was to analyse the prevalence of PAH after a successful VSD closure after the age of 6months and whether there are risk factors for developing PAH. METHODS: Echocardiographic and right heart catheter data of patients with VSD or complete atrioventricular septal defect, who underwent VSD closure after the age of 6months in our institution between 01/2005 and 06/2014, were retrospectively analyzed...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27863742/nanoparticle-transport-and-delivery-in-a-heterogeneous-pulmonary-vasculature
#19
Salman Sohrabi, Shunqiang Wang, Jifu Tan, Jiang Xu, Jie Yang, Yaling Liu
Quantitative understanding of nanoparticles delivery in a complex vascular networks is very challenging because it involves interplay of transport, hydrodynamic force, and multivalent interactions across different scales. Heterogeneous pulmonary network includes up to 16 generations of vessels in its arterial tree. Modeling the complete pulmonary vascular system in 3D is computationally unrealistic. To save computational cost, a model reconstructed from MRI scanned images is cut into an arbitrary pathway consisting of the upper 4-generations...
November 10, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27861431/pediatric-artificial-lung-a-low-resistance-pumpless-artificial-lung-alleviates-an-acute-lamb-model-of-increased-right-ventricle-afterload
#20
Fares Alghanem, Benjamin S Bryner, Emilia M Jahangir, Uditha P Fernando, John M Trahanas, Hayley R Hoffman, Robert H Bartlett, Alvaro Rojas-Peña, Ronald B Hirschl
Lung disease in children often results in pulmonary hypertension and right heart failure. The availability of a pediatric artificial lung (PAL) would open new approaches to the management of these conditions by bridging to recovery in acute disease or transplantation in chronic disease. This study investigates the efficacy of a novel PAL in alleviating an animal model of pulmonary hypertension and increased right ventricle afterload.Five juvenile lambs (20-30 Kg) underwent PAL implantation in a pulmonary artery to left atrium configuration...
November 15, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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