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Pulmonary vascular resistance

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https://www.readbyqxmd.com/read/28331450/pulmonary-thromboendarterectomy-for-pulmonary-hypertension-before-considering-transplant
#1
Hannah Kooperkamp, Inder Mehta, David Fary, Michael Bates
BACKGROUND: In cases of chronic thromboembolic pulmonary hypertension (CTEPH), referral for possible surgical intervention is important because surgery can be curative. Surgery necessitates cardiopulmonary bypass and deep circulatory arrest with pulmonary thrombectomy and bilateral endarterectomy (PTE). If surgery fails, lung transplant is the next best surgical option. Medical treatment is also an important adjunct. CASE REPORT: A 35-year-old female presented 3 months after a pulmonary embolus was found to be completely occluding her left pulmonary artery...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28330686/imaging-of-acute-and-chronic-thromboembolic-disease-state-of-the-art
#2
REVIEW
A Ruggiero, N J Screaton
Acute pulmonary embolism (PE) is a life-threatening condition that requires prompt diagnosis and treatment. Recent advances in imaging allow acute and rapid recognition even by the non-specialist radiologist. Most acute emboli resolve on anticoagulation without sequelae; however, some emboli fail to fully resolve becoming endothelialised with the development of chronic thromboembolic disease (CTED). Increased pulmonary vascular resistance arising from CTED may lead to chronic thromboembolic pulmonary hypertension (CTEPH) a debilitating disease affecting up to 5% of survivors of acute PE...
March 19, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28329315/seraphin-haemodynamic-sub-study-the-effect-of-the-dual-endothelin-receptor-antagonist-macitentan-on-haemodynamic-parameters-and-nt-probnp-levels-and-their-association-with-disease-progression-in-patients-with-pulmonary-arterial-hypertension
#3
Nazzareno Galiè, Pavel Jansa, Tomás Pulido, Richard N Channick, Marion Delcroix, Hossein-Ardeschir Ghofrani, Franck-Olivier Le Brun, Sanjay Mehta, Loïc Perchenet, Lewis J Rubin, B K S Sastry, Gérald Simonneau, Olivier Sitbon, Rogério Souza, Adam Torbicki
Aims: The effect of macitentan on haemodynamic parameters and NT-proBNP levels was evaluated in pulmonary arterial hypertension (PAH) patients in the SERAPHIN study. Association between these parameters and disease progression, assessed by the primary endpoint (time to first morbidity/mortality event), was explored. Methods and results: Of the 742 randomized patients, 187 with right heart catheterization at baseline and month 6 participated in a haemodynamic sub-study...
February 28, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28329267/right-ventricular-recovery-after-bilateral-lung-transplantation-for-pulmonary-arterial-hypertension%C3%A2
#4
Thomas M Gorter, Erik A M Verschuuren, Dirk J van Veldhuisen, Elke S Hoendermis, Michiel E Erasmus, Harm J Bogaard, Anton Vonk Noordegraaf, Rolf M F Berger, Joost P van Melle, Tineke P Willems
OBJECTIVES: Pulmonary arterial hypertension (PAH) is a progressive and often fatal disease characterized by increased pulmonary vascular resistance (PVR) and right ventricular (RV) failure. End-stage PAH is often an indication for a lung transplant (LTX). Our goal was to study ventricular recovery using cardiac magnetic resonance imaging late after LTX. METHODS: We studied 10 patients with PAH who underwent isolated bilateral LTX. RV and left ventricular (LV) volumes, function and mass were measured...
March 3, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28326855/impact-of-postoperative-pulmonary-hypertension-on-outcome-after-heart-transplantation
#5
Jakob Lundgren, Carl Söderlund, Göran Rådegran
OBJECTIVES: We wanted to investigate the effects of postoperative pulmonary hypertension (PHpostop: mean pulmonary artery pressure [MPAP] ≥ 25 mmHg), diastolic pressure gradient (DPG), pulmonary vascular resistance (PVR), and repeated hemodynamic measurements on long-term survival after heart transplantation (HT). DESIGN: Eighty-nine patients who underwent HT at Skåne University Hospital in Lund in the period 1988-2010 and who were evaluated with right-heart-catheterization at rest, prior to HT and repeatedly during the first postoperative year, were grouped based on their MPAP, DPG, and PVR...
March 22, 2017: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/28323904/pyrrolidine-dithiocarbamate-administered-during-ex-vivo-lung-perfusion-promotes-rehabilitation-of-injured-donor-rat-lungs-obtained-after-prolonged-warm-ischemia
#6
Cyril Francioli, Xingyu Wang, Roumen Parapanov, Etienne Abdelnour, Jérôme Lugrin, Fabrizio Gronchi, Jean Perentes, Philippe Eckert, Hans-Beat Ris, Lise Piquilloud, Thorsten Krueger, Lucas Liaudet
Damaged lung grafts obtained after circulatory death (DCD lungs) and warm ischemia may be at high risk of reperfusion injury after transplantation. Such lungs could be pharmacologically reconditioned using ex-vivo lung perfusion (EVLP). Since acute inflammation related to the activation of nuclear factor kappaB (NF-κB) is instrumental in lung reperfusion injury, we hypothesized that DCD lungs might be treated during EVLP by pyrrolidine dithiocarbamate (PDTC), an inhibitor of NF-κB. Rat lungs exposed to 1h warm ischemia and 2 h cold ischemia were subjected to EVLP during 4h, in absence (CTRL group, N = 6) or in presence of PDTC (2...
2017: PloS One
https://www.readbyqxmd.com/read/28321539/secoisolariciresinol-diglucoside-attenuates-cardiac-hypertrophy-and-oxidative-stress-in-monocrotaline-induced-right-heart-dysfunction
#7
Stephanie Puukila, Rafael Oliveira Fernandes, Patrick Türck, Cristina Campos Carraro, Jéssica Hellen Poletto Bonetto, Bruna Gazzi de Lima-Seolin, Alex Sander da Rosa Araujo, Adriane Belló-Klein, Douglas Boreham, Neelam Khaper
Pulmonary arterial hypertension (PAH) occurs when remodeling of pulmonary vessels leads to increased pulmonary vascular resistance resulting in increased pulmonary arterial pressure. Increased pulmonary arterial pressure results in right ventricle hypertrophy and eventually heart failure. Oxidative stress has been implicated in the pathogenesis of PAH and may play a role in the regulation of cellular signaling involved in cardiac response to pressure overload. Secoisolariciresinol diglucoside (SDG), a component from flaxseed, has been shown to reduce cardiac oxidative stress in various pathophysiological conditions...
March 20, 2017: Molecular and Cellular Biochemistry
https://www.readbyqxmd.com/read/28320897/vascular-narrowing-in-pulmonary-arterial-hypertension-is-heterogeneous-rethinking-resistance
#8
Nina Rol, Esther M Timmer, Theo J C Faes, Anton Vonk Noordegraaf, Katrien Grünberg, Harm-Jan Bogaard, Nico Westerhof
In idiopathic pulmonary arterial hypertension (PAH), increased pulmonary vascular resistance is associated with structural narrowing of small (resistance) vessels and increased vascular tone. Current information on pulmonary vascular remodeling is mostly limited to averaged increases in wall thickness, but information on number of vessels affected and internal diameter decreases for vessels of different sizes is limited. Our aim was to quantify numbers of affected vessels and their internal diameter decrease for differently sized vessels in PAH in comparison with non-PAH patients...
March 2017: Physiological Reports
https://www.readbyqxmd.com/read/28317625/relationship-among-pulmonary-hypertension-autoimmunity-thyroid-hormones-and-dyspnea-in-patients-with-hyperthyroidism
#9
Sayid Shafi Zuhur, Derya Baykiz, Sonat Pinar Kara, Ertan Sahin, Idris Kuzu, Gulsah Elbuken
OBJECTIVE: Previous studies have reported conflicting results regarding the mechanisms underlying the pathophysiology of pulmonary hypertension (PHT) in patients with hyperthyroidism. Therefore, in this study, we investigated the association between PHT and thyroid-stimulating hormone (TSH) receptor antibody, thyroid peroxidase antibody, thyroglobulin antibody, TSH, fT3, fT4 and dyspnea during daily activities in a large population of patients with hyperthyroidism. METHODS: A total of 129 consecutive patients with hyperthyroidism, 37 with hypothyroidism and 38 euthyroid controls were enrolled in this study...
April 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28317064/altered-synchrony-of-right-ventricular-contraction-in-borderline-pulmonary-hypertension
#10
Bouchra Lamia, Jean-François Muir, Luis-Carlos Molano, Catherine Viacroze, Jacques Benichou, Philippe Bonnet, Jean Quieffin, Antoine Cuvelier, Robert Naeije
Imaging studies have shown that pulmonary hypertension (PH) is associated with inhomogenous right ventricular (RV) regional contraction, or dyssynchrony, and that this is of prognostic relevance. This study aimed at the identification and functional significance of RV dyssynchrony in borderline PH defined by a mean pulmonary artery pressure between (mPAP) 20 and 25 mmHg. RV dyssynchrony was measured by 2-dimensional speckle tracking echocardiography in 17 patients with pulmonary arterial hypertension (PAH), 13 patients with borderline PH and 14 controls...
March 19, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28316030/a-new-ct-score-as-index-of-hemodynamic-changes-in-patients-with-chronic-thromboembolic-pulmonary-hypertension
#11
Maria Barbara Leone, Marica Giannotta, Massimiliano Palazzini, Mariano Cefarelli, Sofia Martìn Suàrez, Enrico Gotti, Maria Letizia Bacchi Reggiani, Maurizio Zompatori, Nazzareno Galiè
PURPOSE: The aim of this study was to retrospectively assess the relationship between radiological and hemodynamic parameters in patients with chronic thromboembolic pulmonary hypertension (CTEPH). We introduced a new CT-score to evaluate hemodynamic changes, only employing CT-pulmonary angiography (CTPA). MATERIALS AND METHODS: 145 patients affected by CTEPH underwent hemodynamic and CTPA evaluation. Among these 145 patients, 69 underwent pulmonary endarterectomy (PEA) and performed a CTPA evaluation even after surgery...
March 18, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28315943/hyperoxia-reduces-oxygen-consumption-in-children-with-pulmonary-hypertension
#12
Long Guo, Prashant Bobhate, Shine Kumar, Karunakar Vadlamudi, Tarek Kaddoura, Mohamed Elgendi, Paula Holinski, James Y Coe, Jennifer Rutledge, Ian Adatia
High inspired oxygen concentration (FiO2 > 0.85) is administered to test pulmonary vascular reactivity in children with pulmonary hypertension (PH). It is difficult to measure oxygen consumption (VO2) if the subject is breathing a hyperoxic gas mixture so the assumption is made that baseline VO2 does not change. We hypothesized that hyperoxia changes VO2. We sought to compare the VO2 measured by a thermodilution catheter in room air and hyperoxia. A retrospective review of the hemodynamic data obtained in children with PH who underwent cardiac catheterization was conducted between 2009 and 2014...
March 18, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28315502/the-effect-of-left-ventricular-assist-device-therapy-in-patients-with-heart-failure-and-mixed-pulmonary-hypertension
#13
Hoong S Lim, Neil Howell, Aaron Ranasinghe
BACKGROUND: Diastolic pressure gradient (DPG) of ≥7 mmHg has been proposed to distinguish mixed pulmonary hypertension from isolated post-capillary pulmonary hypertension in heart failure (HF). We evaluated the changes in pulmonary hemodynamics with left ventricular assist devices (LVADs) in patients with DPG of ≥7 or <7 mmHg, and effects on peak oxygen uptake (VO2) in patients with advanced HF. METHODS: Pre- and post-LVAD implant pulmonary hemodynamics (including right atrial (RA) pressures, DPG, pulmonary vascular resistance (PVR), pulmonary capacitance (PCap) and cardiac output), echocardiography, cardiopulmonary exercise test were measured in 38 consecutive patients...
March 16, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28303869/-5-year-surgical-results-in-patients-with-chronic-postembolic-pulmonary-hypertension
#14
A M Chernyavsky, A G Edemsky, M A Chernyavsky, A R Tarkova, E N Kliver, S N Ivanov
AIM: To evaluate 5-year results of surgical treatment of patients with chronic postembolic pulmonary hypertension. MATERIAL AND METHODS: 170 patients with chronic postembolic pulmonary hypertension underwent pulmonary thrombendarterectomy. Mean age was 48±21.5 years. The operation was carried out using standard technique with hypothermia and circulatory arrest. We have analyzed clinical and functional status of 47 patients (23 males) prior to surgery and in long-term postoperative period (5-6 years)...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28291667/medical-therapy-versus-balloon-angioplasty-for-cteph-a-systematic-review-and-meta-analysis
#15
Kevin Phan, Helen E Jo, Joshua Xu, Edmund M Lau
BACKGROUND: A significant number of chronic thromboembolic pulmonary hypertension (CTEPH) patients will have an inoperable disease. Medical therapy and balloon pulmonary angioplasty (BPA) have provided alternate therapeutic options for patients with inoperable CTEPH, although there are a limited number of published studies examining the outcomes. Thus, our study aims to evaluate and compare the efficacy of medical therapy and BPA in patients with inoperable CTEPH. METHODS: An electronic search of six databases was performed and the search results were screened against established criteria for inclusion into this study...
March 1, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28290895/-hemodynamic-predictors-of-clinical-deterioration-in-patients-with-pulmonary-arterial-hypertension-associated-with-systemic-scleroderma
#16
E V Nikolaeva, I A Kurmukov, N N Yudkina, S I Glukhova, A V Volkov
OBJECTIVE: to elucidate hemodynamic predictors of clinical deterioration (CD) in patients with pulmonary arterial hypertension (PAH) associated with systemic scleroderma (SSD). MATERIAL AND METHODS: We included into this study 48 patients with PAH-SSD consecutively admitted in 2004-2014. At inclusion all patients underwent right heart catheterization (RHC) and thereafter were under dynamic observation. CD deterioration was diagnosed in the presence of the following: >15% decline in 6-minute walk test distance; worsening of PAH functional class; intensification of symptoms of right ventricular failure; necessity in administration of parenteral diuretics...
October 2016: Kardiologiia
https://www.readbyqxmd.com/read/28290794/-hemodynamic-derangements-in-patients-with-functional-univentricular-heart-mechanisms-of-development-possibilities-of-treatment
#17
I A Kovalev, S Ovroutski, I V Plotnikova, A A Tupikina
Heart failure (HF) is a predictable outcome of nearly all cardiovascular diseases including congenital heart diseases (CHD). A special category comprises patients with functional single ventricle (FSV) of the heart because of extreme diversity of anatomical changes of the heart and great vessels, complex mechanisms of development of HF, multistage surgical correction of the defect, presence of arrhythmias, progressive rise of pulmonary vascular resistance, etc. Prevention and treatment of HF in patients with FSV includes surgical optimization of pulmonary blood flow during neonatal period, timely staged surgical correction of the defect, pharmacotherapy, cardiac resynchronization therapy, and in severe cases mechanical cardiac support and heart transplantation...
February 2017: Kardiologiia
https://www.readbyqxmd.com/read/28289721/platelets-from-pulmonary-hypertension-patients-show-increased-mitochondrial-reserve-capacity
#18
Quyen L Nguyen, Catherine Corey, Pamela White, Annie Watson, Mark T Gladwin, Marc A Simon, Sruti Shiva
Accumulating evidence suggests that altered cellular metabolism is systemic in pulmonary hypertension (PH) and central to disease pathogenesis. However, bioenergetic changes in PH patients and their association with disease severity remain unclear. Here, we hypothesize that alteration in bioenergetic function is present in platelets from PH patients and correlates with clinical parameters of PH. Platelets isolated from controls and PH patients (n = 28) were subjected to extracellular flux analysis to determine oxygen consumption and glycolytic rates...
March 9, 2017: JCI Insight
https://www.readbyqxmd.com/read/28287506/assessment-of-pulmonary-capillary-blood-volume-membrane-diffusing-capacity-and-intrapulmonary-arteriovenous-anastomoses-during-exercise
#19
Vincent Tedjasaputra, Sean van Diepen, Sophie É Collins, Wade M Michaelchuk, Michael K Stickland
Exercise is a stress to the pulmonary vasculature. With incremental exercise, the pulmonary diffusing capacity (DLCO) must increase to meet the increased oxygen demand; otherwise, a diffusion limitation may occur. The increase in DLCO with exercise is due to increased capillary blood volume (Vc) and membrane diffusing capacity (Dm). Vc and Dm increase secondary to the recruitment and distension of pulmonary capillaries, increasing the surface area for gas exchange and decreasing pulmonary vascular resistance, thereby attenuating the increase in pulmonary arterial pressure...
February 20, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28283234/endothelin-inhibitors-lower-pulmonary-vascular-resistance-and-improve-functional-capacity-in-patients-with-fontan-circulation
#20
Gabriella Agnoletti, Simona Gala, Francesca Ferroni, Roberto Bordese, Lorenzo Appendini, Carlo Pace Napoleone, Laura Bergamasco
OBJECTIVES: To evaluate the effects of endothelin inhibitors (ERAs) on hemodynamic and functional parameters in patients post-Fontan procedure with high pulmonary vascular resistance (PVR). METHODS: Among our cohort of patients with Fontan circulation, 8 children, 8 adolescents, and 8 adults had PVR ≥2 WU*m(2). These patients were treated with ERAs (minors with bosentan, adults with macitentan) and reevaluated after 6 months. Pre- and posttreatment hemodynamic variables were assessed by cardiac catheterization...
February 10, 2017: Journal of Thoracic and Cardiovascular Surgery
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