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CT pulmonary hypertension

D Valenzuela, F Moya, M Luco, J L Tapia
50 years ago, Northway described Broncopulmonary Dysplasia (BPD) in preterm infants exposed to mechanical ventilation. Since then, their survival has increased, nevertheless a "new BPD" has appeared and its incidence has not diminished. One of the characteristics of this pathology is the the abnormal vascular remodeling, which in its most severe expression is known as Pulmonary Hyper tension (PH); with an incidence of 17% in patients with BPD, which is proportional to the severity of the disease (33% in severe BPD), and as mortality factor (up to 48% 2-year mortality in PH-BPD)...
December 2017: Revista Chilena de Pediatría
Benjamin J Currie, Chris Johns, Matthew Chin, Thanos Charalampopolous, Charlie A Elliot, Pankaj Garg, Smitha Rajaram, Catherine Hill, Jim W Wild, Robin A Condliffe, David G Kiely, Andy J Swift
BACKGROUND: Patients with pulmonary hypertension due to left heart disease (PH-LHD) have overlapping clinical features with pulmonary arterial hypertension making diagnosis reliant on right heart catheterization (RHC). This study aimed to investigate computed tomography pulmonary angiography (CTPA) derived cardiopulmonary structural metrics, in comparison to magnetic resonance imaging (MRI) for the diagnosis of left heart disease in patients with suspected pulmonary hypertension. METHODS: Patients with suspected pulmonary hypertension who underwent CTPA, MRI and RHC were identified...
March 4, 2018: International Journal of Cardiology
Yoshinari Enomoto, Go Hashimoto, Naohiko Sahara, Hikari Hashimoto, Hiroki Niikura, Keijiro Nakamura, Raisuke Iijima, Hidehiko Hara, Makoto Suzuki, Mahito Noro, Masao Moroi, Kaoru Sugi, Masato Nakamura
A 70-years-old male with a history of hypertension and drug resistant paroxysmal atrial fibrillation (AF) presented to our hospital for catheter ablation to his symptomatic AF. He had no prior surgical or percutaneous procedure to close or exclude the left atrial appendage (LAA). A transesophageal echocardiography (TEE) was performed to rule out intra-cardiac thrombus prior to the ablation procedure. Although the TEE imaging at multiple acquisition angles was obtained, the LAA could not be visualized and an absence of the LAA was suspected...
March 12, 2018: International Heart Journal
Ji Young Rho, David A Lynch, Young Ju Suh, Jeung Weon Nah, Jordan A Zach, Joyce D Schroeder, Christian W Cox, Russell P Bowler, Brett E Fenster, Mark T Dransfield, James M Wells, John E Hokanson, Douglas Curran-Everett, Andre Williams, MeiLan K Han, James D Crapo, Edwin K Silverman
To identify a predictive value for the exacerbation status of chronic obstructive pulmonary disease (COPD) subjects, we evaluated the relationship between pulmonary vascular measurements on chest CT and severe COPD exacerbation.Six hundred three subjects enrolled in the COPDGene population were included and divided into nonexacerbator (n = 313) and severe exacerbator (n = 290) groups, based on whether they had an emergency room visit and/or hospitalization for COPD exacerbation. We measured the diameter of the main pulmonary artery (MPA) and ascending aorta (AA) at 2 different sites of the MPA (the tubular midportion and bifurcation) on both axial images and multiplanar reconstructions...
January 2018: Medicine (Baltimore)
G Donatini, J L Kraimps, C Caillard, E Mirallie, F Pierre, Loïc De Calan, Hamy Antoine, O Larin, O Tovkay, S Cherenko
BACKGROUND: Pheochromocytoma (PHEO) in pregnancy is a life-threatening condition. Its management is challenging with regards to the timing and type of surgery. METHODS: A retrospective review of the management of ten patients diagnosed with pheochromocytoma during pregnancy was performed. Data were collected on the initial diagnostic workup, symptoms, treatment, and follow-up. RESULTS: PHEO was diagnosed in ten patients who were between the 10th and the 29th weeks of pregnancy...
February 27, 2018: Surgical Endoscopy
Shohei Okazaki, Takanori Abe, Natsuko Takayanagi, Masanori Yasuda, Fumikazu Sakai, Kunihiko Kobayashi, Shingo Kato
BACKGROUND/AIM: We report on a case of pulmonary tumor embolism caused by squamous cell carcinoma of the uterine cervix. PATIENTS AND METHODS: A 60-year-old female diagnosed with stage IVB (cT4N1M1) squamous cell carcinoma of the uterine cervix was admitted to our institution with a chief complaint of progressive dyspnea that developed within a few days after admission. RESULTS: A chest CT scan showed dilated pulmonary arteries, right ventricular enlargement and mosaic ground-glass opacities in both lungs...
March 2018: In Vivo
Narasa Madam, Wassim Mosleh, Natdanai Punnanithinont, Andres Carmona-Rubio, Zaid H Said, Umesh C Sharma
Background: Pulmonary hypertension (PH) is an underdiagnosed cause for chest pain in patients without significant coronary artery disease (CAD). Studies showed that enlarged pulmonary arterial (PA) and right ventricular chamber sizes correlate with the severity of PH. Therefore, we studied the association between chest pain, right ventricular dimensions (RVDs), and PA size on coronary coronary tomographic angiography (CCTA). Methods: The CCTA of 87 patients presenting with chest pain without evidence of obstructive CAD was examined...
2018: Clinical Medicine Insights. Circulatory, Respiratory and Pulmonary Medicine
Hironobu Sugiyama, Ryo Tohma, Takuya Misato, Kazuma Okamoto, Taro Hayashi, Satoshi Tobe, Tatsuro Matsuo, Kotaro Tsunemi, Takanori Oka, Nobuhiro Tanimura
We report a rare case of right heart failure caused by distal aortic aneurysm. Although aortopulmonary fistula is a common complication of giant aortic arch aneurysm, right heart failure caused by mechanical pressure by aneurysm is very rare. A 79-year-old female patient presented dyspnea. Contrast computed tomography (CT) of the thorax delineated a 78 mm aortic arch aneurysm pressing the main to left pulmonary artery and a 40 mm pericardial effusion at maximum depth at posterior side. Echocardiography showed the acceleration flow from main to left pulmonary artery and moderate pulmonary hypertension...
February 17, 2018: General Thoracic and Cardiovascular Surgery
Gisela M B Meyer, Fernanda B Spilimbergo, Stephan Atmayer, Gabriel S Pacini, Matheus Zanon, Guilherme Watte, Edson Marchiori, Bruno Hochhegger
INTRODUCTION: Our goal was to assess the diagnostic performance of magnetic resonance imaging (MRI) as a single method to diagnose pulmonary hypertension (PH) compared to right heart catheterization (RHC), computed tomography (CT), and ventilation/perfusion (V/Q) scintigraphy. METHODS: We identified 35 patients diagnosed with PH by RHC in our institution who have also undergone a CT, a scintigraphy, and an MRI within a month. All cases were discussed in multidisciplinary meetings...
February 12, 2018: Lung
Felipe Aluja Jaramillo, Fernando R Gutierrez, Federico G Díaz Telli, Sebastian Yevenes Aravena, Cylen Javidan-Nejad, Sanjeev Bhalla
Pulmonary hypertension (PH) is a condition characterized by increased pressure in the pulmonary circulation. It may be idiopathic or arise in the setting of other clinical conditions. Patients with PH tend to present with nonspecific cardiovascular or respiratory symptoms. The clinical classification of PH was recently revised at the World Health Organization symposium in Nice, France, in 2013. That consensus statement provided an updated classification based on the shared hemodynamic characteristics and management of the different categories of PH...
February 12, 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Nadia D Morgan, Ami A Shah, Maureen D Mayes, Robyn T Domsic, Thomas A Medsger, Virginia D Steen, John Varga, Mary Carns, Paula S Ramos, Richard M Silver, Elena Schiopu, Dinesh Khanna, Vivien Hsu, Jessica K Gordon, Heather Gladue, Lesley A Saketkoo, Lindsey A Criswell, Chris T Derk, Marcin A Trojanowski, Victoria K Shanmugam, Lorinda Chung, Antonia Valenzuela, Reem Jan, Avram Goldberg, Elaine F Remmers, Daniel L Kastner, Fredrick M Wigley, Pravitt Gourh, Francesco Boin
Racial differences exist in the severity of systemic sclerosis (SSc). To enhance our knowledge about SSc in African Americans, we established a comprehensive clinical database from the largest multicenter cohort of African American SSc patients assembled to date (the Genome Research in African American Scleroderma Patients (GRASP) cohort).African American SSc patients were enrolled retrospectively and prospectively over a 30-year period (1987-2016), from 18 academic centers throughout the United States. The cross-sectional prevalence of sociodemographic, clinical, and serological features was evaluated...
December 2017: Medicine (Baltimore)
Virginia Chamorro, Daniel Morales-Cano, Javier Milara, Bianca Barreira, Laura Moreno, María Callejo, Gema Mondejar-Parreño, Sergio Esquivel-Ruiz, Julio Cortijo, Ángel Cogolludo, Joan A Barberá, Francisco Perez-Vizcaino
INTRODUCTION: Current treatment with vasodilators for pulmonary hypertension associated with respiratory diseases is limited by their inhibitory effect on hypoxic pulmonary vasoconstriction (HPV) and uncoupling effects on ventilation-perfusion (V'/Q'). Hypoxia is also a well-known modulator of the nitric oxide (NO) pathway, and may therefore differentially affect the responses to phosphodiesterase 5 (PDE5) inhibitors and soluble guanylyl cyclase (sGC) stimulators. So far, the effects of the sGC stimulator riociguat on HPV have been poorly characterized...
2018: PloS One
Tongxi Liu, Li Gao, Sheng Xie, Hongliang Sun, Min Liu, Zhenguo Zhai
PURPOSE: Fibrosing mediastinitis (FM) is a rare disorder characterized by an excessive fibrotic reaction within the mediastinum, which can result in compression of mediastinal structures. To investigate the clinical and imaging characteristics of TB-associated FM, patients with evidence of TB infection were retrospectively evaluated in this study. MATERIALS AND METHODS: A total of 33 patients with clinically diagnosed FM and evidence of TB infection were selected from the database of two institutional medical centers...
January 22, 2018: Clinical Respiratory Journal
Shinichirou Ishimoto, Hiroyuki Sakurai, Ryouta Higure, Riken Kawachi, Mie Shimamura
Pulmonary artery aneurysms (PAA) and pseudoaneurysms (PAP) are caused by infections, vasculitis, trauma, pulmonary hypertension, congenital heart disease, and connective tissue disease. Most cases of such aneurysm occur in the trunk or major branches of the pulmonary artery, while the peripheral type is less common. The treatment modalities are medical therapy, surgery, and percutaneous catheter embolization. The mortality rate associated with rupture is approximately 50%. We encountered a case of a 53-year-old man with a pulmonary artery pseudoaneurysm secondary to pneumonia and cavity formation during chemotherapy for acute myeloid leukemia (AML)...
January 15, 2018: Annals of Thoracic and Cardiovascular Surgery
Ping Wang, Ling Yuan, Juhong Shi, Zuojun Xu
Background: Isolated unilateral absence of pulmonary artery (UAPA) in adulthood is a rare congenital anomaly. Although some case reports exist, the clinical symptomatology, lung parenchymal features, collateral circulation and therapeutic approaches in adult patients with isolated UAPA remain unknown. The objectives of this study are to investigate the clinical characteristics, elucidate the correlation between clinical symptomatology and radiology, and summarize treatment of adult patients with isolated UAPA...
December 2017: Journal of Thoracic Disease
Byron A Zambrano, Nathan A McLean, Xiaodan Zhao, Ju-Le Tan, Liang Zhong, C Alberto Figueroa, Lik Chuan Lee, Seungik Baek
Pulmonary arterial hypertension (PAH) is a disease characterized by an elevated pulmonary arterial (PA) pressure. While several computational hemodynamic models of the pulmonary vasculature have been developed to understand PAH, they are lacking in some aspects, such as the vessel wall deformation and its lack of calibration against measurements in humans. Here, we describe a computational modeling framework that addresses these limitations. Specifically, computational models describing the coupling of hemodynamics and vessel wall mechanics in the pulmonary vasculature of a PAH patient and a normal subject were developed...
December 27, 2017: Journal of Biomechanics
Zhiwei Zhai, Hideki Ota, Marius Staring, Jan Stolk, Koichiro Sugimura, Kei Takase, Berend C Stoel
OBJECTIVES: Balloon pulmonary angioplasty (BPA) in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) can have variable outcomes. To gain more insight into this variation, we designed a method for visualizing and quantifying changes in pulmonary perfusion by automatically comparing computed tomography (CT) pulmonary angiography before and after BPA treatment. We validated these quantifications of perfusion changes against hemodynamic changes measured with right-sided heart catheterization...
December 22, 2017: Investigative Radiology
Christopher S Johns, Jim M Wild, Smitha Rajaram, Andy J Swift, David G Kiely
Pulmonary hypertension (PH) is a challenging condition to diagnose and treat. Over the last two decades, there have been significant advances in therapeutic approaches and imaging technologies. Current guidelines emphasize the importance of cardiac catheterization; however, the increasing availability of non-invasive imaging has the potential to improve diagnostic rates, whilst providing additional information on patient phenotypes. Areas covered: This review discusses the role of imaging in the diagnosis, prognostic assessment and follow-up of patients with PH...
February 2018: Expert Review of Respiratory Medicine
Carrie P Aaron, Joseph E Schwartz, Eric A Hoffman, Elsa Angelini, John H M Austin, Mary Cushman, David R Jacobs, Joel D Kaufman, Andrew Laine, Lewis J Smith, Jie Yang, Karol E Watson, Russell P Tracy, R Graham Barr
BACKGROUND: Platelet activation reduces pulmonary microvascular blood flow and contributes to inflammation; these factors have been implicated in the pathogenesis of COPD and emphysema. We hypothesized that regular use of aspirin, a platelet inhibitor, would be associated with a slower progression of emphysema-like lung characteristics on CT imaging and a slower decline in lung function. METHODS: The Multi-Ethnic Study of Atherosclerosis (MESA) enrolled participants 45 to 84 years of age without clinical cardiovascular disease from 2000 to 2002...
December 12, 2017: Chest
Joseph Jacob, Brian J Bartholmai, Srinivasan Rajagopalan, Ronald Karwoski, Arjun Nair, Simon L F Walsh, Joseph Barnett, Gary Cross, Eoin P Judge, Maria Kokosi, Elisabetta Renzoni, Toby M Maher, Athol U Wells
BACKGROUND AND OBJECTIVE: This study evaluated whether patients with combined pulmonary fibrosis and emphysema (CPFE) have an increased likelihood of pulmonary hypertension (PHT) when compared with idiopathic pulmonary fibrosis (IPF) patients without emphysema. METHODS: Two consecutive IPF populations having undergone transthoracic echocardiography were examined (n = 223 and n = 162). Emphysema and interstitial lung disease (ILD) extent were quantified visually; ILD extent was also quantified by a software tool, CALIPER...
December 13, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
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