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Pulmonary vascular resistance

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https://www.readbyqxmd.com/read/28633352/aortopulmonary-window-results-of-repair-beyond-infancy%C3%A2
#1
Sachin Talwar, Bharat Siddharth, Saurabh Kumar Gupta, Shiv Kumar Choudhary, Shyam Sunder Kothari, Rajnish Juneja, Anita Saxena, Balram Airan
OBJECTIVES: To study the anatomic and haemodynamic data and results of surgery in patients undergoing surgical repair of aortopulmonary window beyond infancy. METHODS: Between July 2005 and December 2015, 23 patients, older than 1 year undergoing surgery for aortopulmonary window were analysed retrospectively. Postoperative clinical and echocardiography follow-up were performed. RESULTS: Median age and weight at repair was 4 years (range 14 months-12 years) and 12 kg (range 3...
June 13, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28631764/-hemodynamic-effects-of-positive-end-expiratory-pressure
#2
Marco Marini, Giorgio Caretta, Fabio Vagnarelli, Fabiana Lucà, Emilia Biscottini, Alberto Lavorgna, Vincenza Procaccini, Letizia Riva, Gabriele Vianello, Nadia Aspromonte, Andrea Mortara, Renata De Maria, Piera Capasso, Serafina Valente, Michele Massimo Gulizia
The application of a positive end-expiratory pressure (PEEP), the cornerstone of noninvasive ventilation (NIV), causes hemodynamic changes in the cardiovascular system. To understand the benefits of NIV it is necessary to resume concepts of cardiovascular physiology and pathophysiology about cardiac function determinants, venous return, ventricular interdependence and heart-lung interaction, and to understand how PEEP interacts with them. The hemodynamic effects of PEEP are mediated by the increase in transpulmonary pressure, which results in increased pulmonary vascular resistance and in an attending small reduction of venous return in conditions of euvolemia, in a substantial reduction of left ventricular afterload and a potential positive effect on left ventricular stroke volume...
June 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28626160/effect-of-anemia-on-cardiovascular-hemodynamics-therapeutic-strategy-and-clinical-outcomes-in-patients-with-heart-failure-and-hemodynamic-congestion
#3
Muneyoshi Tanimura, Kaoru Dohi, Naoki Fujimoto, Keishi Moriwaki, Taku Omori, Yuichi Sato, Emiyo Sugiura, Naoto Kumagai, Shiro Nakamori, Tairo Kurita, Eitaro Fujii, Norikazu Yamada, Masaaki Ito
BACKGROUND: We investigated the effect of anemia on cardiovascular hemodynamics, therapeutic strategies and clinical outcomes in heart failure (HF) patients.Methods and Results:We divided 198 consecutive HF patients who underwent right heart catheterization before in-hospital HF treatment into 2 groups according to the presence or absence of hemodynamic congestion (HC: mean pulmonary capillary wedge pressure ≥15 mmHg and/or mean right atrial pressure ≥10 mmHg). The hemoglobin level correlated with the cardiac index (CI) and systemic vascular resistance index (SVRI) (r=-0...
June 17, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28626080/cyp2c44-mediated-decrease-of-15-hete-exacerbates-pulmonary-hypertension
#4
Gábor Á Fülöp, Andriy Yabluchanskiy
Pulmonary hypertension (PH) is a progressive disease characterized by elevated pulmonary arterial pressure and pulmonary vascular resistance. According to latest estimations, a PH incidence accounts for 1% of total global population (up to 5 million people) and the median survival rate for patients diagnosed with PH is predicted at 2.8 years. Emerging evidence suggests an important role for cytochrome P450 in the development and progression of PH, as a newer member of cytochrome family Cyp2c44 has been recently implicated in mediating hypoxia-induced pulmonary artery remodeling...
June 16, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28621582/assessment-of-pulmonary-arterial-compliance-evaluated-using-harmonic-oscillator-kinematics
#5
Yasunobu Hayabuchi, Akemi Ono, Yukako Homma, Shoji Kagami
We hypothesized that KPA, a harmonic oscillator kinematics-derived spring constant parameter of the pulmonary artery pressure (PAP) profile, reflects PA compliance in pediatric patients. In this prospective study of 33 children (age range = 0.5-20 years) with various cardiac diseases, we assessed the novel parameter designated as KPA calculated using the pressure phase plane and the equation KPA = (dP/dt_max)(2)/([Pmax - Pmin])/2)(2), where dP/dt_max is the peak derivative of PAP, and Pmax - Pmin is the difference between the minimum and maximum PAP...
June 16, 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28616281/clinicopathological-factors-influenced-the-prognosis-of-surgically-resected-pulmonary-pleomorphic-carcinoma
#6
Katsuhiro Okuda, Risa Oda, Ayumi Suzuki, Tadashi Sakane, Osamu Kawano, Hiroshi Haneda, Satoru Moriyama, Ryoichi Nakanishi
BACKGROUND: Pulmonary pleomorphic carcinoma has made an unfavorable prognosis because of its properties of resisting radiation and chemotherapy, and its aggressive growth. The correlation between clinicopathological factors and prognosis about pulmonary pleomorphic carcinoma patients who received its surgical resection has not been clearly identified. METHODS: We retrospectively investigated the clinical records of 24 pulmonary pleomorphic carcinoma patients who had a surgical resection from January 2004 to December 2013 at our institute...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28609431/polymorphisms-in-urea-cycle-enzyme-genes-are-associated-with-persistent-pulmonary-hypertension-of-the-newborn
#7
Dinushan C Kaluarachchi, Caitlin J Smith, Jonathan M Klein, Jeffrey C Murray, John M Dagle, Kelli K Ryckman
BACKGROUND: Persistent pulmonary hypertension of the newborn (PPHN) is characterized by elevated pulmonary vascular resistance. Endogenous nitric oxide is critical for regulation of pulmonary vascular resistance. Nitric oxide is generated from L -arginine, supplied by the urea cycle (UC). We hypothesized that polymorphisms in UC enzyme genes and low concentrations of UC intermediates are associated with PPHN. METHODS: We performed a family based candidate gene analysis to study 48 single nucleotide polymorphisms (SNPs) in 6 UC enzyme genes...
June 13, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28606099/pulmonary-hemodynamics-and-effects-of-phosphodiesterase-type-5-inhibition-in-heart-failure-a-meta-analysis-of-randomized-trials
#8
In-Chang Hwang, Yong-Jin Kim, Jun-Bean Park, Yeonyee E Yoon, Seung-Pyo Lee, Hyung-Kwan Kim, Goo-Yeong Cho, Dae-Won Sohn
BACKGROUND: Previous studies suggested that phosphodiesterase 5 inhibitors (PDE5i) have a beneficial effect in patients with heart failure (HF), although the results were inconsistent. We performed a meta-analysis to evaluate the effect of PDE5i in HF patients, and investigated the relationship between PDE5i effects and pulmonary hemodynamics. METHOD: We searched PubMed, EMBASE and the Cochrane Library for randomized controlled trials (RCTs) that compared PDE5i with placebo in HF with reduced ejection fraction (HFrEF) or HF with preserved EF (HFpEF)...
June 12, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28600088/invasive-hemodynamics-of-pulmonary-disease-and-the-right-ventricle
#9
REVIEW
David Silber, Justine Lachmann
Pulmonary hypertension (PH) falls into 5 groups, as defined by the World Health Organization. Swan-Ganz catheters determine precapillary versus postcapillary PH. The hemodynamic values of PH at rest and with vasodilatory challenge categorize the etiology of PH and guide treatment. RV maladaptations to increased pulmonary vascular resistance (PVR) and the chronicity of the right ventricle's (RV) response to increased PH and/or increased PVR can be understood with pressure-volume (PV) loops constructed with use of conductance catheters...
July 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28598920/aerosolized-vasodilators-for-the-treatment-of-pulmonary-hypertension-in-cardiac-surgical-patients-a-systematic-review-and-meta-analysis
#10
Mahsa Elmi-Sarabi, Alain Deschamps, Stéphane Delisle, Hosham Ased, François Haddad, Yoan Lamarche, Louis P Perrault, Jean Lambert, Alexis F Turgeon, André Y Denault
BACKGROUND: In cardiac surgery, pulmonary hypertension is an important prognostic factor for which several treatments have been suggested over time. In this systematic review and meta-analysis, we compared the efficacy of inhaled aerosolized vasodilators to intravenously administered agents and to placebo in the treatment of pulmonary hypertension during cardiac surgery. We searched MEDLINE, CENTRAL, EMBASE, Web of Science, and clinicaltrials.gov databases from inception to October 2015...
June 7, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28598912/cardiac-output-measurements-based-on-the-pulse-wave-transit-time-and-thoracic-impedance-exhibit-limited-agreement-with-thermodilution-method-during-orthotopic-liver-transplantation
#11
Aurora Magliocca, Emanuele Rezoagli, Thomas Anthony Anderson, Sara Maria Burns, Fumito Ichinose, Hovig Vatche Chitilian
BACKGROUND: Orthotopic liver transplantation (OLT) is characterized by significant intraoperative hemodynamic variability. Accurate and real-time cardiac output (CO) monitoring aids clinical decision making during OLT. The purpose of this study is to compare accuracy, precision, and trending ability of CO estimation obtained noninvasively using pulse wave transit time (estimated continuous cardiac output [esCCO; Nihon Kohden, Tokyo, Japan]) or thoracic bioimpedance (ICON; Osypka Medical GmbH, Berlin, Germany) to thermodilution cardiac output (TDCO) measured with a pulmonary artery catheter...
June 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28597779/phosphodiesterase-type-5-inhibitor-to-riociguat-transition-is-associated-with-hemodynamic-and-symptomatic-improvement-in-pulmonary-hypertension
#12
Ryan Davey, Raymond L Benza, Srinivas Murali, Amresh Raina
Riociguat is a soluble guanylate cyclase stimulator approved for the treatment of pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension. We studied the clinical and hemodynamics effects of transitioning 12 pulmonary hypertension patients from Phosphodiesterase type 5 inhibitor (PDE5i) to riociguat, and demonstrated a significant increase in cardiac index, fall in pulmonary vascular resistance, and improvement in functional class with this switch. Switch from PDE5i to riociguat appeared to be safe and fairly well tolerated in most patients...
April 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28597774/combination-therapy-in-pulmonary-arterial-hypertension-recent-accomplishments-and-future-challenges
#13
Annie-Christine Lajoie, Sebastien Bonnet, Steeve Provencher
Pulmonary arterial hypertension (PAH) is a life-threatening disease characterized by a progressive increase in pulmonary vascular resistance, ultimately leading to right heart failure and death. Throughout the past 20 years, numerous specific pharmacologic agents, including phosphodiesterase-5 inhibitors, endothelin receptor antagonists, prostaglandins, and more recently, soluble guanylate cyclase stimulators and selective IP prostacyclin receptor agonist, have emerged for the treatment of PAH. Early clinical trials were typically of short-term duration, comparing the effects of PAH-targeted therapies versus placebo and using exercise tolerance as the primary endpoint in most trials...
April 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28597771/first-in-child-use-of-the-oral-selective-prostacyclin-ip-receptor-agonist-selexipag-in-pulmonary-arterial-hypertension
#14
Lianne M Geerdink, Harald Bertram, Georg Hansmann
Pulmonary arterial hypertension (PAH) is a complex disease with a poor prognosis. Selexipag is a selective prostacyclin receptor agonist with vasodilatory, anti-proliferative, anti-inflammatory, and pro-angiogenic properties. However, no clinical data on its therapeutic use in children with PAH are currently available. Here, we report the case of a 12-year-old girl who presented in World Health Organization (WHO) functional class III and right ventricular (RV) failure with recurrent syncope, dizziness, and progressive fatigue for two years...
April 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28597758/longitudinal-change-in-pulmonary-arterial-capacitance-as-an-indicator-of-prognosis-and-response-to-therapy-and-in-pulmonary-arterial-hypertension
#15
Sarah K Medrek, Chad Kloefkorn, Duc T M Nguyen, Edward A Graviss, Adaani E Frost, Zeenat Safdar
Pulmonary arterial hypertension (PAH) is a chronic progressive disease that leads to right heart failure and death. Pulmonary arterial capacitance (PAC), defined as stroke volume divided by the pulmonary pulse pressure, has been identified as a prognostic factor in PAH. The impact of changes in PAC over time, however, is unclear. We evaluated changes in PAC over time to determine if such changes predicted transplant-free survival. A single-center retrospective study of consecutive group 1 PAH patients who had two or more right heart catheterizations (RHC) between January 2007 and June 2016 was undertaken...
April 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28597757/the-cancer-theory-of-pulmonary-arterial-hypertension
#16
Olivier Boucherat, Geraldine Vitry, Isabelle Trinh, Roxane Paulin, Steeve Provencher, Sebastien Bonnet
Pulmonary arterial hypertension (PAH) remains a mysterious killer that, like cancer, is characterized by tremendous complexity. PAH development occurs under sustained and persistent environmental stress, such as inflammation, shear stress, pseudo-hypoxia, and more. After inducing an initial death of the endothelial cells, these environmental stresses contribute with time to the development of hyper-proliferative and apoptotic resistant clone of cells including pulmonary artery smooth muscle cells, fibroblasts, and even pulmonary artery endothelial cells allowing vascular remodeling and PAH development...
April 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28597399/effects-of-levosimendan-on-patients-with-heart-failure-complicating-acute-coronary-syndrome-a-meta-analysis-of-randomized-controlled-trials
#17
REVIEW
Guokai Shang, Xinyan Yang, Daijun Song, Yun Ti, Yuanyuan Shang, Zhihao Wang, Mengxiong Tang, Yun Zhang, Wei Zhang, Ming Zhong
BACKGROUND: The prognosis for patients with heart failure (HF), including cardiogenic shock (CS), complicating acute coronary syndrome (ACS) remains poor. OBJECTIVE: This study aimed to review the relevant literature and evaluate whether levosimendan was associated with better clinical outcomes in these patients. METHODS: We searched PubMed, EMBASE, and the Cochrane library databases for randomized controlled trials that investigated levosimendan compared with any control in patients with HF/CS complicating ACS...
June 8, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/28596435/balloon-pulmonary-angioplasty-for-inoperable-patients-with-chronic-thromboembolic-pulmonary-hypertension-the-initial-german-experience
#18
Karen M Olsson, Christoph B Wiedenroth, Jan-Christopher Kamp, Andreas Breithecker, Jan Fuge, Gabriele A Krombach, Moritz Haas, Christian Hamm, Thorsten Kramm, Stefan Guth, Hossein Ardeschir Ghofrani, Jan B Hinrichs, Serghei Cebotari, Katrin Meyer, Marius M Hoeper, Eckhard Mayer, Christoph Liebetrau, Bernhard C Meyer
Balloon pulmonary angioplasty (BPA) is an emerging treatment for patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH).We report on a prospective series of 56 consecutive patients who underwent 266 BPA interventions (median, five per patient) at two German institutions. All patients underwent a comprehensive diagnostic work-up including right heart catheterisation at baseline and 24 weeks after their last intervention.BPA resulted in improvements in WHO functional class, 6 min walk distance (mean change, +33 m), right ventricular function and haemodynamics, including a decline in mean pulmonary artery pressure by 18% and in pulmonary vascular resistance by 26%...
June 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28592589/right-heart-end-systolic-remodeling-index-strongly-predicts-outcomes-in-pulmonary-arterial-hypertension-comparison-with-validated-models
#19
COMPARATIVE STUDY
Myriam Amsallem, Andrew J Sweatt, Marie C Aymami, Tatiana Kuznetsova, Mona Selej, HongQuan Lu, Olaf Mercier, Elie Fadel, Ingela Schnittger, Michael V McConnell, Marlene Rabinovitch, Roham T Zamanian, Francois Haddad
BACKGROUND: Right ventricular (RV) end-systolic dimensions provide information on both size and function. We investigated whether an internally scaled index of end-systolic dimension is incremental to well-validated prognostic scores in pulmonary arterial hypertension. METHODS AND RESULTS: From 2005 to 2014, 228 patients with pulmonary arterial hypertension were prospectively enrolled. RV end-systolic remodeling index (RVESRI) was defined by lateral length divided by septal height...
June 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28591785/results-from-more-than-20%C3%A2-years-of-surgical-pulmonary-endarterectomy-for-chronic-thromboembolic-pulmonary-hypertension-in-denmark
#20
Kasper Korsholm, Asger Andersen, Søren Mellemkjær, Dorthe Viemose Nielsen, Kaj Erik Klaaborg, Lars Bo Ilkjær, Jens Erik Nielsen-Kudsk
OBJECTIVES: Chronic thromboembolic pulmonary hypertension is a fatal disease if left untreated, and pulmonary endarterectomy (PEA) is the potentially curable treatment of choice. We aimed to estimate the current in-hospital mortality rate, complication rate and long-term survival for patients with chronic thromboembolic pulmonary hypertension undergoing PEA in Denmark. METHODS: All chronic thromboembolic pulmonary hypertension patients who underwent PEA in the period 1994 till 2016 were consecutively enrolled in our single-centre study...
June 7, 2017: European Journal of Cardio-thoracic Surgery
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