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https://www.readbyqxmd.com/read/28821335/symptoms-are-more-useful-than-echocardiography-in-patient-selection-for%C3%A2-pulmonary-endarterectomy
#1
Laura Donahoe, Rachel Vanderlaan, John Thenganatt, Karen McRae, Anastasia Bykova, Jakov Moric, John Granton, Marc de Perrot
BACKGROUND: Chronic thromboembolic pulmonary hypertension (CTEPH) is still largely underdiagnosed in the general population. Although transthoracic echocardiogram (TTE) is recommended to screen for CTEPH, it may not detect patients with chronic thromboembolic disease (CTED) and mild or exercise-induced pulmonary hypertension (PH) who could also benefit from pulmonary endarterectomy (PEA). METHODS: All patients referred to our CTEPH program with persistent mismatched perfusion defects on ventilation-perfusion (VQ) scan between January 2005 and June 2015 were divided into three groups according to TTE and right heart catheterization (RHC) as follows: (1) typical CTEPH group (PH on RHC and TTE), (2) TTE-negative (neg) CTEPH group (PH on RHC, but not TTE), or (3) CTED group (no PH on RHC and TTE)...
August 16, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28819305/cardiorespiratory-pathogenesis-of-sickle-cell-disease-in-a-mouse-model
#2
Jun Ren, Xiuqing Ding, Marie Trudel, John J Greer, Joanna E MacLean
The nature and development of cardiorespiratory impairments associated with sickle cell disease are poorly understood. Given that the mechanisms of these impairments cannot be addressed adequately in clinical studies, we characterized cardiorespiratory pathophysiology from birth to maturity in the sickle cell disease SAD mouse model. We identified two critical phases of respiratory dysfunction in SAD mice; the first prior to weaning and the second in adulthood. At postnatal day 3, 43% of SAD mice showed marked apneas, anemia, and pulmonary vascular congestion typical of acute chest syndrome; none of these mice survived to maturity...
August 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28817465/new-insights-into-the-recognition-classification-and-management-of-systemic-sclerosis-associated-pulmonary-hypertension
#3
Christopher J Mullin, Stephen C Mathai
PURPOSE OF REVIEW: Pulmonary hypertension is a common complication of systemic sclerosis (SSc), and remains a leading cause of morbidity and mortality. We will review recent developments in the recognition, classification and treatment of pulmonary hypertension in SSc. RECENT FINDINGS: Advances in screening for pulmonary arterial hypertension (PAH) and use of exercise haemodynamics may help to identify pulmonary vascular disease earlier in SSc. Recent studies have led to changes in recommendations for adjunct therapy and selection of pulmonary vasodilators for the treatment of SSc-associated PAH...
August 16, 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/28797049/effect-of-sodium-bicarbonate-on-prolonged-running-performance-a-randomized-double-blind-cross-over-study
#4
Tanja Freis, Anne Hecksteden, Ulf Such, Tim Meyer
BACKGROUND: The ability to sustain intense exercise seems to be partially limited by the body's capability to counteract decreases in both intra- and extracellular pH. While the influence of an enhanced buffering capacity via sodium bicarbonate (BICA) on short-term, high-intensity exercise performance has been repeatedly investigated, studies on prolonged endurance performances are comparatively rare, especially for running. The aim of the following study was to assess the ergogenic effects of an oral BICA substitution upon exhaustive intensive endurance running performance...
2017: PloS One
https://www.readbyqxmd.com/read/28782712/effects-of-fasudil-on-pulmonary-hypertension-in-clinical-practice
#5
REVIEW
Yiqing Zhang, Shangjie Wu
Pulmonary hypertension (PH) is a pathophysiologic disorder that may involve multiple clinical conditions and can complicate the majority of cardiovascular and respiratory diseases. The presence of PH is associated with worse outcomes, but the efficacy of current therapy is still unsatisfactory. Because Rho-kinase (ROCK) plays an important role in the pathogenesis of PH, the ROCK inhibitor fasudil is expected to contribute to PH treatment. In animal models of PH, fasudil reduced pulmonary artery pressure (PAP) and improved survival...
August 4, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28782152/virtual-protein-purification-a-simple-exercise-to-introduce-ph-as-a-parameter-that-effects-ion-exchange-chromatography
#6
Daniel D Clark, Daniel J Edwards
This article describes a simple exercise using a free, easy-to-use, established online program. The exercise helps to reinforce protein purification concepts and introduces undergraduates to pH as a parameter that affects anion-exchange chromatography. The exercise was tested with biochemistry majors at California State University-Chico. Given the versatility of the program, this work is also a model for instructors that wish to develop their own exercise to help teach other protein purification techniques...
August 6, 2017: Biochemistry and Molecular Biology Education
https://www.readbyqxmd.com/read/28775065/effect-of-hypoxia-and-hyperoxia-on-exercise-performance-in-healthy-individuals-and-in-patients-with-pulmonary-hypertension-a-systematic-review
#7
Silvia Ulrich, Simon Raphael Schneider, Konrad E Bloch
Exercise performance is determined by oxygen supply to working muscles and vital organs. In healthy individuals, exercise performance is limited in the hypoxic environment at altitude, when oxygen delivery is diminished due to the reduced alveolar and arterial oxygen partial pressures. In patients with pulmonary hypertension, exercise performance is already reduced near sea level due to impairments of the pulmonary circulation and gas exchange and, presumably, these limitations are more pronounced at altitude...
August 3, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28767527/bioenergetics-and-atp-synthesis-during-exercise-role-of-group-iii-iv-muscle-afferents
#8
Ryan M Broxterman, Gwenael Layec, Thomas J Hureau, David E Morgan, Amber D Bledsoe, Jacob E Jessop, Markus Amann, Russell S Richardson
PURPOSE: To investigate the role of the group III/IV muscle afferents in the bioenergetics of exercising skeletal muscle beyond constraining the magnitude of metabolic perturbation. METHODS: Eight healthy men, performed intermittent isometric knee-extensor exercise to task failure at ~58% maximal voluntary contraction (MVC) under control conditions (CTRL) and with lumbar intrathecal fentanyl to attenuate group III/IV leg muscle afferents (FENT). Intramuscular concentrations of phosphocreatine (PCr), inorganic phosphate (Pi), diprotonated phosphate (H2PO4¯), adenosine triphosphate (ATP), and pH were determined using phosphorous magnetic resonance spectroscopy (P-MRS)...
July 31, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28763443/intermittent-hypoxic-training-improves-anaerobic-performance-in-competitive-swimmers-when-implemented-into-a-direct-competition-mesocycle
#9
Miłosz Czuba, Robert Wilk, Jakub Karpiński, Małgorzata Chalimoniuk, Adam Zajac, Józef Langfort
The main objective of this research was to evaluate the efficacy of intermittent hypoxic training (IHT) on anaerobic and aerobic capacity and swimming performance in well-trained swimmers. Sixteen male swimmers were randomly divided into a hypoxia (H) group (n = 8), which trained in a normobaric hypoxia environment, and a control (C) group (n = 8), which exercised under normoxic conditions. However, one participant left the study without explanation. During the experiment group H trained on land twice per week in simulated hypoxia (FiO2 = 15...
2017: PloS One
https://www.readbyqxmd.com/read/28756079/-exercise-testing-new-guidelines
#10
Dany Michel Marcadet
The GERS (Exercise Rehabilitation and Sports Group of the French Society of Cardiology) has decided to update current guidelines regarding the practice of EKG stress tests. Since the last update dates from 1997, the GERS judged it necessary to integrate data from new works and advancements made in the last 20 years. Good clinical practices and safety conditions are better defined regarding the structure, location, material, staff competency, as well as convention with hospital structures. The diagnosis of coronary artery disease remains the principal indication for a stress test...
July 26, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28736291/clinical-and-hemodynamic-correlates-and-prognostic-value-of-ve-vco2-slope-in-patients-with-heart-failure-with-preserved-ejection-fraction-and-pulmonary-hypertension
#11
Sebastiaan H C Klaassen, Licette C Y Liu, Yoran M Hummel, Kevin Damman, P van der Meer, Adriaan A Voors, Elke S Hoendermis, Dirk J van Veldhuisen
BACKGROUND: Impaired exercise capacity is one of the hallmarks of heart failure with preserved ejection fraction (HFpEF), but the clinical and hemodynamic correlates and prognostic value of exercise testing in patients with HFpEF is unknown. METHODS: Patients with HFpEF (Left ventricular ejection fraction [LVEF] ≥ 45%) and pulmonary hypertension, underwent cardiopulmonary exercise test (CPX) to measure maximal (peak VO2) and sub maximal (ventilatory equivalent for carbon dioxide [VE/VCO2] slope) exercise capacity...
July 20, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28732819/individual-dose-adjustment-of-riociguat-in-patients-with-pulmonary-arterial-hypertension-and-chronic-thromboembolic-pulmonary-hypertension
#12
REVIEW
Nicholas S Hill, Franck F Rahaghi, Namita Sood, Reiner Frey, Hossein-Ardeschir Ghofrani
Riociguat is a soluble guanylate cyclase stimulator that has been approved for the treatment of pulmonary arterial hypertension and inoperable chronic thromboembolic pulmonary hypertension or persistent/recurrent pulmonary hypertension following pulmonary endarterectomy. Riociguat is administered using an 8-week individual dose-adjustment scheme whereby a patient initially receives riociguat 1.0 mg three times daily (tid), and the dose is then increased every 2 weeks in the absence of hypotension, indicated by systolic blood pressure measurements and symptoms, up to a maximum dose of 2...
August 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28722077/invasive-haemodynamic-evaluation-of-the-pulmonary-circulation-in-pulmonary-hypertension
#13
Alberto Pagnamenta, Andrea Azzola, Maurice Beghetti, Frédéric Lador, On Behalf Of The Swiss Society Of Pulmonary Hypertension
The term pulmonary hypertension refers to a serious condition characterised by high pulmonary vascular pressure, mainly as a consequence of various cardiac and respiratory diseases. Current clinical classification of pulmonary hypertension considers five distinct groups. Transthoracic echocardiography represents the first and most important noninvasive screening tool for estimating the probability of pulmonary hypertension. The diagnostic approach to pulmonary hypertension is supported by a proposed algorithm, which identifies the underlying cause...
July 19, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28697935/continuous-countercurrent-tangential-chromatography-for-mixed-mode-post-capture-operations-in-monoclonal-antibody-purification
#14
Amit K Dutta, Dmitriy Fedorenko, Jasmine Tan, Joseph A Costanzo, David S Kahn, Andrew L Zydney, Oleg Shinkazh
Continuous Countercurrent Tangential Chromatography (CCTC) has been shown to demonstrate significant advantages over column chromatography including higher productivity, lower operational pressure, disposable flow path, and lower resin use. Previous applications of CCTC have been limited to initial capture of monoclonal antibodies (mAb) from clarified cell culture harvest. In this present article, a CCTC system was designed and tested for a post-capture antibody purification step. Mixed mode cation exchange-hydrophobic interaction chromatography resins with two different particle sizes were used to reduce host cell protein (HCP), leached protein A, DNA, and aggregates from a mAb stream after a protein A operation...
June 22, 2017: Journal of Chromatography. A
https://www.readbyqxmd.com/read/28695558/rehabilitation-in-patients-with-pulmonary-arterial-hypertension
#15
Stephan Keusch, Alexander Turk, Stéphanie Saxer, Nicola Ehlken, Ekkehard Grunig, Silvia Ulrich, On Behalf Of The Swiss Society Of Pulmonary Hypertension
Exertional dyspnoea is a leading symptom in patients with pulmonary arterial hypertension (PAH). Patients suffering from PAH report poor quality of life, have skeletal muscle dysfunction and in the absence of advanced medical therapy deteriorate progressively due to right heart failure which can lead to death. For decades, patients with PAH were advised to avoid exercise in fear of exacerbated right heart failure. Recently, it has been shown that a highly supervised rehabilitation programme in expert centres leads to significant improvements in symptoms, quality of life, exercise capacity and may even enhance haemodynamics in selected stable patients treated with advanced regimens of PAH-targeted drugs...
July 11, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28687588/the-carotid-baroreflex-modifies-the-pressor-threshold-of-the-muscle-metaboreflex-in-humans
#16
Masashi Ichinose, Tomoko K Ichinose-Kuwahara, Kazuhito Watanabe, Narihiko Kondo, Takeshi Nishiyasu
The purpose of present study was to test our hypothesis that unloading the carotid baroreceptors alters the threshold and gain of the muscle metaboreflex in humans. Ten healthy subjects performed a static handgrip exercise at 50% of maximum voluntary contraction. Contraction was sustained for 15, 30, 45 and 60 s, and was followed by 3 min of forearm circulatory arrest, during which forearm muscular pH is known to decrease linearly with increasing contraction time. The carotid baroreceptors were unloaded by applying 0...
July 7, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28680584/use-of-thermodilution-cardiac-output-overestimates-diagnoses-of-exercise-induced-pulmonary-hypertension
#17
Steven Hsu, Samuel B Brusca, Parker S Rhodes, Todd M Kolb, Stephen C Mathai, Ryan J Tedford
Two new definitions of exercise-induced pulmonary hypertension (EIPH) have emerged. Both rely on measuring cardiac output (CO), yet this remains unstandardized. In our cohort of patients undergoing invasive cardiopulmonary exercise testing, we found that using thermodilution CO rather than direct Fick CO led to a significant excess of EIPH diagnoses.
March 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28680574/chronic-use-of-pah-specific-therapy-in-world-health-organization-group-iii-pulmonary-hypertension-a-systematic-review-and-meta-analysis
#18
Kurt W Prins, Sue Duval, Jeremy Markowitz, Marc Pritzker, Thenappan Thenappan
Pulmonary hypertension (PH) complicating chronic obstructive pulmonary disease (COPD-PH) and interstitial lung disease (ILD-PH) (World Health Organization [WHO] Group III PH) increases medical costs and reduces survival. Despite limited data, many clinicians are using pulmonary arterial hypertension (PAH)-specific therapy to treat WHO Group III PH patients. To further investigate the utility of PAH-specific therapy in WHO Group III PH, we performed a systematic review and meta-analysis. Relevant studies from January 2000 through May 2016 were identified in the MEDLINE, EMBASE, and COCHRANE electronic databases and www...
March 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28680573/treatment-response-in-patients-with-idiopathic-pulmonary-arterial-hypertension-and-a-severely-reduced-diffusion-capacity
#19
Cathelijne E van der Bruggen, Onno A Spruijt, Esther J Nossent, Pia Trip, J Tim Marcus, Frances S de Man, Harm Jan Bogaard, Anton Vonk Noordegraaf
Patients with idiopathic pulmonary arterial hypertension (IPAH) and a reduced diffusion capacity of the lung for carbon monoxide (DLCO) have a worse survival compared to IPAH patients with a preserved DLCO. Whether this poor survival can be explained by unresponsiveness to pulmonary hypertension (PH)-specific vasodilatory therapy is unknown. Therefore, the aim of this study was to evaluate the hemodynamic and cardiac response to PH-specific vasodilatory therapy in patients with IPAH and a reduced DLCO. Retrospectively, we studied treatment naïve hereditary and IPAH patients diagnosed between January 1990 and May 2015 at the VU University Medical Center...
March 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28680563/effects-of-exercise-training-on-pulmonary-hemodynamics-functional-capacity-and-inflammation-in-pulmonary-hypertension
#20
REVIEW
Manuel J Richter, Jan Grimminger, Britta Krüger, Hossein A Ghofrani, Frank C Mooren, Henning Gall, Christian Pilat, Karsten Krüger
Pulmonary hypertension (PH) is characterized by severe exercise limitation mainly attributed to the impairment of right ventricular function resulting from a concomitant elevation of pulmonary vascular resistance and pressure. The unquestioned cornerstone in the management of patients with pulmonary arterial hypertension (PAH) is specific vasoactive medical therapy to improve pulmonary hemodynamics and strengthen right ventricular function. Nevertheless, evidence for a beneficial effect of exercise training (ET) on pulmonary hemodynamics and functional capacity in patients with PH has been growing during the past decade...
March 2017: Pulmonary Circulation
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