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Pulmonary vascular resistance

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https://www.readbyqxmd.com/read/29785232/effects-of-fasudil-on-patients-with-pulmonary-hypertension-associated-with-left-ventricular-heart-failure-with-preserved-ejection-fraction-a-prospective-intervention-study
#1
Xiang Zhang, Xueming Zhang, Saihua Wang, Jun Luo, Zhihong Zhao, Changzhu Zheng, Jieyan Shen
Background: Pulmonary hypertension due to left ventricular heart failure with preserved ejection fraction (PH-HFpEF) is an increasingly medical problem. The aim of the study was to evaluate the clinical efficacy of fasudil on PH-HFpEF elderly patients and to figure out the subtype of PH-HFpEF which may be the therapeutic object of fasudil. Method: 58 PH-HFpEF elderly patients were enrolled. Patients were diagnosed with passive pulmonary hypertension (PPH) or reactive pulmonary hypertension (RPH) by right heart catheterization and all receiving Rho kinase inhibitor fasudil for 2 weeks...
2018: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/29784125/catheter-directed-thrombolysis-for-pulmonary-embolism-the-state-of-practice
#2
Xi Xue, Akhilesh K Sista
Acute pulmonary embolism (PE) is a major public health problem. It is the third most common cause of death in hospitalized patients. In the United States, there are up to 600,000 cases diagnosed per year with 100,000-180,000 acute PE-related deaths. Common risk factors include underlying genetic conditions, acquired conditions, and acquired hypercoagulable states. Acute PE increases the pulmonary vascular resistance and the load on the right ventricle (RV). Increased RV loading causes compensatory RV dilation, impaired contractility, tachycardia, and sympathetic activation...
June 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29782256/-radiofrequency-pulmonary-artery-ablation-for-treatment-of-residual-pulmonary-hypertension-after-pulmonary-endarterectomy
#3
A M CHernyavskiy, A G Edemskiy, N V Novikova, A B Romanov, S N Artemenko, B A Rudenko, A R Tarkova
OBJECTIVE: to assess the safety and efficiency of radiofrequency pulmonary artery ablation for treatment of residual pulmonary hypertension after pulmonary endarterectomy. MATERIAL AND METHODS: Radiofrequency pulmonary artery denervation (PADN) was performed in 16 patients (10 men, mean age 39 years [26; 51]). Indication for PADN was mean pulmonary artery pressure (PAP) >25 mm Hg with absence of proximal pulmonary artery lesion according to computer tomography...
April 2018: Kardiologiia
https://www.readbyqxmd.com/read/29779927/patent-ductus-arteriosus-the-physiology-of-transition
#4
REVIEW
Poorva Deshpande, Michelle Baczynski, Patrick J McNamara, Amish Jain
The transition from intrauterine to extrauterine life represents a critical phase of physiological adaptation which impacts many organ systems, most notably the heart and the lungs. The majority of term neonates complete this transition without complications; however, dysregulation of normal postnatal adaptation may lead to acute cardiopulmonary instability, necessitating advanced intensive care support. Although not as well appreciated as changes in vascular resistances, the shunt across the DA plays a crucial physiologic role in the adaptive processes related to normal transitional circulation...
May 5, 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29772649/pulmonary-arterial-hypertension-pathophysiology-and-treatment
#5
REVIEW
Norris S H Lan, Benjamin D Massam, Sandeep S Kulkarni, Chim C Lang
Pulmonary arterial hypertension (PAH), the first category of pulmonary hypertension, is a chronic and progressive disorder characterised by angioproliferative vasculopathy in the pulmonary arterioles, leading to endothelial and smooth muscle proliferation and dysfunction, inflammation and thrombosis. These changes increase pulmonary vascular resistance and subsequent pulmonary arterial pressure, causing right ventricular failure which leads to eventual death if untreated. The management of PAH has advanced rapidly in recent years due to improved understanding of the condition's pathophysiology, specifically the nitric oxide, prostacyclin-thromboxane and endothelin-1 pathways...
May 16, 2018: Diseases (Basel)
https://www.readbyqxmd.com/read/29763366/right-ventricle-performances-with-echocardiography-and-99m-tc-myocardial-perfusion-imaging-in-pulmonary-arterial-hypertension-patients
#6
Jie Liu, Lei Fei, Guang-Qing Huang, Xiao-Ke Shang, Mei Liu, Zhi-Jun Pei, Yong-Xue Zhang
Right heart catheterization is commonly used to measure right ventricle hemodynamic parameters and is the gold standard for pulmonary arterial hypertension diagnosis; however, it is not suitable for patients' long-term follow-up. Non-invasive echocardiography and nuclear medicine have been applied to measure right ventricle anatomy and function, but the guidelines for the usefulness of clinical parameters remain to be established. The goal of this study is to identify reliable clinical parameters of right ventricle function in pulmonary arterial hypertension patients and analyze the relationship of these clinical parameters with the disease severity of pulmonary arterial hypertension...
May 2018: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/29756460/inhaled-fasudil-lacks-pulmonary-selectivity-in-thromboxane-induced-acute-pulmonary-hypertension-in-newborn-lambs
#7
Shawn F L Hanson, Michael H Terry, Dafne T Moretta, Gordon G Power, Sean M Wilson, Farzana Alam, Fakhrul Ahsan, Arlin B Blood, Paresh C Giri
INTRODUCTION: Pulmonary hypertension (PH) is a potentially deadly disease for infants and adults with few existing medical interventions and no cure. In PH, increased blood pressure in the pulmonary artery eventually leads to heart failure. Fasudil, an antagonist of Rho-kinase, causes vasodilation leading to decreased systemic artery pressure and pulmonary artery pressure (PAP). This study compared the effects of fasudil administered as either an intravenous infusion or inhaled aerosol in newborn lambs...
January 1, 2018: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29756230/the-relationship-between-pulmonary-artery-wedge-pressure-and-pulmonary-blood-volume-derived-from-contrast-echocardiography-a-proof-of-concept-study
#8
Ken Monahan, Daniel Lenihan, Evan L Brittain, Linda Saliba, Robert N Piana, Leslie L Robison, Melissa M Hudson, Gregory T Armstrong
BACKGROUND: Pulmonary transit time (PTT) obtained from contrast echocardiography is a marker of global cardiopulmonary function. Pulmonary blood volume (PBV), derived from PTT, may be a noninvasive surrogate for left-sided filling pressures, such as pulmonary artery wedge pressure (PAWP). We sought to assess the relationship between PBV obtained from contrast echocardiography and PAWP. METHODS: Participants were adult survivors of childhood cancer that had contrast echocardiography performed nearly simultaneously with right-heart catheterization...
May 14, 2018: Echocardiography
https://www.readbyqxmd.com/read/29747005/is-the-adenosine-a-2b-biased-receptor-a-valuable-target-for-the-treatment-of-pulmonary-arterial-hypertension
#9
REVIEW
Mafalda Bessa-Gonçalves, Bruno Bragança, Eduardo Martins-Dias, Paulo Correia-de-Sá, Ana Patrícia Fontes-Sousa
Pulmonary arterial hypertension (PAH) is a maladaptive disorder characterized by increased pulmonary vascular resistance leading to right ventricular failure and death. Adenosine released by injured tissues, such as the lung and heart, influences tissue remodeling through the activation of adenosine receptors. Evidence regarding activation of the low-affinity A2B AR by adenosine points towards pivotal roles of this receptor in processes associated with both acute and chronic lung diseases. Conflicting results exist concerning the beneficial or detrimental roles of the A2B 'biased' receptor in right ventricular failure secondary to PAH...
May 7, 2018: Drug Discovery Today
https://www.readbyqxmd.com/read/29746142/pulmonary-vascular-involvement-in-copd-is-there-a-pulmonary-vascular-phenotype
#10
Gabor Kovacs, Alvar Agusti, Joan Albert Barberà, Bartolome Celli, Gerard Criner, Marc Humbert, Don D Sin, Norbert Voelkel, Horst Olschewski
Although often clinically unrecognized, the pulmonary circulation is frequently affected in patients with chronic obstructive pulmonary disease (COPD), and the presence of pulmonary vascular disease is associated with poor prognosis and frequent exacerbations. In most cases the presenting pulmonary hypertension (PH) is relatively mild, but in a subset of COPD patients, the presence of certain clinical features supports the existence of a "pulmonary vascular phenotype". Such a phenotype would be characterized by severe pre-capillary PH with strongly elevated pulmonary vascular resistance, moderate airflow limitation, severely decreased diffusion capacity for carbon monoxide, normo- or hypocapnia, circulatory exercise limitation and progressive right heart failure...
May 10, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29735421/3-bromopyruvate-reverses-hypoxia-induced-pulmonary-arterial-hypertension-through-inhibiting-glycolysis-in-vitro-and-in-vivo-studies
#11
Fangzheng Chen, Heng Wang, Jiadan Lai, Shujing Cai, Linbo Yuan
BACKGROUND: Pulmonary arterial smooth muscle cell (PASMC) proliferation is vital to pulmonary vascular remodeling in pulmonary arterial hypertension (PAH) pathogenesis, and inhibiting PASMC metabolism could serve as a new possible therapy to reverse the process. 3-Bromopyruvate (3-BrPA) is an effective glycolysis inhibitor with its effect in PAH remains unclear. Our study aims to assess the therapeutic effect of 3-BrPA in PAH rats and investigate the possible mechanism of 3-BrPA in PASMC proliferation and apoptosis...
May 4, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29727214/hemodynamic-effects-of-incremental-lung-hyperinflation
#12
William Spencer Cheyne, Jinelle C M Gelinas, Neil Derek Eves
Dynamic hyperinflation (DH) is common in COPD and is associated with dyspnea and exercise intolerance. DH also has adverse cardiac effects, though the magnitude of DH and the mechanisms responsible for the hemodynamic impairment remain unclear. We hypothesized that incrementally increasing DH would systematically reduce left-ventricular (LV) end diastolic volume (LVEDV) and stroke volume (LVSV) due to direct ventricular interaction (DVI). Twenty-three healthy subjects (22{plus minus}2yrs) were exposed to varying degrees of expiratory loading to induce DH such that inspiratory capacity (IC) was decreased by 25, 50, 75 and 100%, (100% DH = IC of resting tidal volume plus inspiratory reserve volume ≈0...
May 4, 2018: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29726017/effect-of-cerebral-flow-autoregulation-function-on-cerebral-flow-rate-under-continuous-flow-left-ventricular-assist-device-support
#13
Selim Bozkurt
Neurological complications in continuous flow left ventricular assist device (CF-LVAD) patients are the second-leading risk of death after multi-organ failure. They are associated with altered blood flow in the cardiovascular system because of CF-LVAD support. Moreover, an impaired cerebral autoregulation function may also contribute to complications such as hyperperfusion in the cerebral circulation under mechanical circulatory support. The aim of this study is to evaluate the effect of cerebral autoregulatory function on cerebral blood flow rate under CF-LVAD support...
May 3, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29720395/pulmonary-arterial-hypertension-in-adult-congenital-heart-disease
#14
REVIEW
Margarita Brida, Michael A Gatzoulis
Pulmonary arterial hypertension (PAH) is commonly associated with congenital heart disease (CHD) and relates to type of the underlying cardiac defects and repair history. Large systemic to pulmonary shunts may develop PAH if untreated or repaired late. PAH, when present, markedly increases morbidity and mortality in patients with CHD. Significant progress has been made for patients with Eisenmenger syndrome in pathophysiology, prognostication and disease-targeting therapy (DTT), which needs to be applied to routine patient care...
May 2, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29715592/fucoidan-vegf-based-surface-modification-of-decellularized-pulmonary-heart-valve-improves-the-antithrombotic-and-re-endothelialization-potential-of-bioprostheses
#15
N Marinval, M Morenc, M N Labour, A Samotus, A Mzyk, V Ollivier, M Maire, K Jesse, K Bassand, A Niemiec-Cyganek, O Haddad, M P Jacob, F Chaubet, N Charnaux, P Wilczek, H Hlawaty
Decellularized porcine heart valves offer promising potential as biocompatible prostheses. However, this procedure alter matrix fibres and glycans, leading to lower biomechanical resistance and increased their thrombotic potential. Therefore, their durability is limited due to calcification and weak regeneration in vivo. Surface modifications are highly requested to improve the scaffolds re-endothelialization required to restore functional and haemocompatible heart valve. Fucoidan, a natural sulphated polysaccharide, carries antithrombotic and anti-inflammatory properties and is known to enhance endothelial adhesion and proliferation when associated with vascular endothelial growth factor (VEGF)...
March 16, 2018: Biomaterials
https://www.readbyqxmd.com/read/29715164/early-versus-delayed-use-of-ultrasound-assisted-catheter-directed-thrombolysis-in-patients-with-acute-submassive-pulmonary-embolism
#16
Sushruth Edla, Howard Rosman, Saroj Neupane, Andrew Boshara, Susan Szpunar, Edouard Daher, David Rodriguez, Thomas LaLonde, Hiroshi Yamasaki, Rajendra H Mehta, Antonious Attallah
OBJECTIVES: The effect of early vs delayed use of ultrasound-assisted catheter-directed thrombolysis (USAT) on invasive hemodynamics and in-hospital outcomes in patients with acute submassive pulmonary embolism (PE) is not well known. METHODS: We evaluated 41 patients with submassive PE to study the association of early USAT (≤24 hours; n = 21) vs delayed USAT (>24 hours; n = 20) with change in invasive hemodynamic measures from pre USAT to post USAT. RESULTS: Significantly greater improvement was observed in the early USAT group compared to the delayed group for median cardiac index (0...
May 2018: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29713934/effects-of-percutaneous-lvad-support-on-right-ventricular-load-and-adaptation
#17
Jeffrey P Yourshaw, Prabodh Mishra, M Christopher Armstrong, Bhavadharini Ramu, Michael L Craig, Adrian B Van Bakel, Daniel H Steinberg, Thomas G DiSalvo, Ryan J Tedford, Brian A Houston
Both operative and hemodynamic mechanisms have been implicated in right heart failure (RHF) following surgical left ventricular assist device (LVAD) implantation. We investigated the effects of percutaneous LVAD (pLVAD; Impella®, Abiomed) support on right ventricular (RV) load and adaptation. We reviewed all patients receiving a pLVAD for cardiogenic shock at our institution between July 2014 and April 2017, including only those with pre- and post-pLVAD invasive hemodynamic measurements. Hemodynamic data was recorded immediately prior to pLVAD implantation and up to 96 h post-implantation...
April 30, 2018: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/29713818/right-ventriculo-arterial-uncoupling-and-impaired-contractile-reserve-in-obese-patients-with-unexplained-exercise-intolerance
#18
Colm McCabe, Rudolf K F Oliveira, Farbod Rahaghi, Mariana Faria-Urbina, Luke Howard, Richard G Axell, Andrew N Priest, Aaron B Waxman, David M Systrom
BACKGROUND: Right ventricular (RV) dysfunction and heart failure with preserved ejection fraction may contribute to exercise intolerance in obesity. To further define RV exercise responses, we investigated RV-arterial coupling in obesity with and without development of exercise pulmonary venous hypertension (ePVH). METHODS: RV-arterial coupling defined as RV end-systolic elastance/pulmonary artery elastance (Ees/Ea) was calculated from invasive cardiopulmonary exercise test data in 6 controls, 8 obese patients without ePVH (Obese-ePVH) and 8 obese patients with ePVH (Obese+ePVH) within a larger series...
April 30, 2018: European Journal of Applied Physiology
https://www.readbyqxmd.com/read/29710689/pulmonary-hemodynamic-effects-and-pulmonary-arterial-compliance-during-hypovolemic-shock-and-reinfusion-with-human-relaxin-2-serelaxin-treatment-in-a-sheep-model
#19
René Schiffner, Thomas Lehmann, Sabine J Bischoff, Timo Zippelius, Marius Nistor, Martin Schmidt
BACKGROUND: Previous studies on the recombinant form of human relaxin-2 (serelaxin) have shown a decrease of pulmonary hemodynamics after serelaxin injection. Currently, the effect of serelaxin treatment during hypovolemia in a large animal model remains mostly unknown. METHODS: 12 sheep were randomly assigned to a sham or serelaxin (30μg/kg serelaxin) group and underwent right heart catheterization. 50% of the estimated total blood volume were removed to induce hypovolemia, and subsequently retransfused 20 min later (reinfusion)...
April 14, 2018: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/29710468/bucindolol-attenuates-the-vascular-remodeling-of-pulmonary-arteries-by-modulating-the-expression-of-the-endothelin-1-a-receptor-in-rats-with-pulmonary-arterial-hypertension
#20
Bruna Gazzi de Lima-Seolin, Matheus Mittmann Hennemann, Rafael Oliveira Fernandes, Rafael Colombo, Jéssica Hellen Poletto Bonetto, Rayane Brinck Teixeira, Neelam Khaper, Alessandra Eifler Guerra Godoy, Isnard Elman Litvin, Alex Sander da Rosa Araujo, Paulo Cavalheiro Schenkel, Adriane Belló-Klein
The aim of this study was to investigate the role of the ß-adrenergic blocker bucindolol on endothelial dysfunction and pulmonary vascular remodeling in rats with pulmonary arterial hypertension (PAH). Male Wistar rats were divided into four groups: control, monocrotaline (MCT), control?+?bucindolol and monocrotaline?+?bucindolol (MCT?+?BCD). PAH was induced by an injection of monocrotaline (60?mg/kg i.p.). After two weeks, the animals were treated for seven days with bucindolol (2?mg/kg/day i.p.) or vehicle...
March 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
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