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CT pulmonary hypertension

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https://www.readbyqxmd.com/read/27920514/usefulness-of-the-6-minute-walk-test-as-a-screening-test-for-pulmonary-arterial-enlargement-in-copd
#1
Yutaro Oki, Masahiro Kaneko, Yukari Fujimoto, Hideki Sakai, Shogo Misu, Yuji Mitani, Takumi Yamaguchi, Hisafumi Yasuda, Akira Ishikawa
PURPOSE: Pulmonary hypertension and exercise-induced oxygen desaturation (EID) influence acute exacerbation of COPD. Computed tomography (CT)-detected pulmonary artery (PA) enlargement is independently associated with acute COPD exacerbations. Associations between PA to aorta (PA:A) ratio and EID in patients with COPD have not been reported. We hypothesized that the PA:A ratio correlated with EID and that results of the 6-minute walk test (6MWT) would be useful for predicting the risk associated with PA:A >1...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27890994/quantitative-computed-tomography-imaging-in-chronic-obstructive-pulmonary-disease
#2
REVIEW
Lalita Fernandes, Yasmin Fernandes, Anthony Menezes Mesquita
Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease having small airway inflammation, emphysema, and pulmonary hypertension. It is now clear that spirometry alone cannot differentiate each component. Quantitative computed tomography (QCT) is increasingly used to quantify the amount of emphysema and small airway involvement in COPD. Inspiratory CT guides in assessing emphysema while expiratory CT identifies areas of air trapping which is a surrogate of small airway inflammation. By constructing a three-dimensional model of airways, we can also measure the airway wall thickness of segmental and subsegmental airways...
November 2016: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/27873231/atherosclerotic-renal-artery-stenosis
#3
Robert Schoepe, Stephen McQuillan, Debbie Valsan, Geoffrey Teehan
Atherosclerotic Renal Artery Stenosis is a form or peripheral arterial disease that tends to affect older subjects with hyperlipidemia, history of tobacco use, and who have other coexistent forms of vascular insufficiency. An abdominal bruit on physical exam can be a helpful clue. Slowly progressive, it can lead to critical narrowing of the renal arteries which creates a cascade of events such as renin-angiotensin-aldosterone activation (RAAS), hypertension, acute pulmonary edema, and renal fibrosis. The hypertension is considered a secondary form and can even be resistant to multiple antihypertensives...
November 22, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27872786/congenital-diaphragmatic-hernia-with-delayed-presentation
#4
Alireza Malekzadegan, Alireza Sargazi
Congenital diaphragmatic hernia (CDH) is caused due to abnormal formation of the muscular parts of diaphragm. The incidence of CDH in common births ranges from 1/25000 to 1/30000. Pulmonary hypoplasia and pulmonary hypertension are factors that associate with the increase of mortality and morbidity due to CDH. We presented a 68-year-old Iranian woman with abdominal pain and tenderness in right upper quadrant who was diagnosed as having CDH. The disease was detected using chest X-ray and chest and abdomen sonography and confirmed with chest and abdomen CT scan with and without oral contrast...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27869490/congenital-diaphragmatic-hernia-causing-cardiac-arrest-in-a-30-year-old-woman
#5
H J Manson, Y M Goh, P Goldsmith, P Scott, P Turner
Congenital diaphragmatic hernia (CDH) usually presents in infancy with respiratory failure requiring urgent surgical correction. Mortality in this group of patients remains poor and persistent pulmonary hypertension is a significant contributor. It is therefore rare for patients to reach adulthood undiagnosed. CDH is often identified incidentally in adults but when symptoms arise, they relate to the organ involved, and include gastrointestinal symptoms of dyspepsia and obstruction, as well as respiratory complaints such as dyspnoea...
November 21, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27869103/th-17-cytokines-and-interstitial-lung-involvement-in-systemic-sclerosis
#6
G Rolla, E Fusaro, S Nicola, C Bucca, C Peroni, S Parisi, M C Cassinis, A Ferraris, F Angelino, E Heffler, M Boita, L Brussino
The two phenotypes of both limited and diffuse systemic sclerosis (SSc) have different forms of pulmonary involvement: pulmonary arterial hypertension (limited phenotype) or interstitial lung disease (ILD) (diffuse phenotype). We aimed to investigate whether Th17-related cytokines, as measured in exhaled breath condensate (EBC) and in serum were connected to ILD in diffuse SSc patients. We found that for both limited and diffuse SSc, the EBC levels of all cytokines and most of the cytokine serum levels were significantly higher in patients than in controls, while, the EBC levels of Th-17 cytokines and the serum levels of IL-10 and TNF-α were significantly higher in diffuse than in limited SSc...
November 21, 2016: Journal of Breath Research
https://www.readbyqxmd.com/read/27865180/detection-of-right-ventricular-myocardial-fibrosis-using-quantitative-ct-attenuation-of-the-right-ventricular-myocardium-in-the-late-phase-on-320-slice-ct-in-subjects-with-pulmonary-hypertension
#7
Koya Ozawa, Nobusada Funabashi, Hiroyuki Takaoka, Nobuhiro Tanabe, Koichiro Tatsumi, Yoshio Kobayashi
PURPOSE: Right ventricular myocardial (RVM) fibrosis may be a significant indicator of prognosis in pulmonary hypertension (PH). To detect the presence of RVM fibrosis in PH subjects, we employed ECG gated 320-slice CT. METHODS: 62 confirmed PH subjects (16 males; 55±16years; 45 chronic thromboembolic PH (CTEPH) who underwent conventional non-surgical medical therapy; and 17 pulmonary arterial hypertension (PAH)) underwent ECG-gated 320-slice CT. On CT, RV fibrosis was defined as contrast defect in the early phase and conversely abnormal enhancement in the late phase...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27852386/-association-between-genetic-polymorphisms-of-hif-2%C3%AE-gene-and-high-altitude-pulmonary-hypertension-in-han-population
#8
Z K Yu, Y J Han, D D Chen, X F Zhang, R Chang
Objective: To test the hypothesis that the single nucleotide polymorphisms (SNPs) in HIF-2α gene were associated with the susceptibility of high altitude pulmonary hypertension (HAPH) in Han population in China. Methods: Those Han population who emigrated to plateau (average altitude 3 300 m) and have been lived here for more than 20 years were included as the research subjects, the method of cluster random sampling was used to enroll 49 HAPH patients as the case group (HAPH group) and 39 free of HAPH people as the control group...
November 1, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27852365/-the-study-of-growth-differentiation-factor-15-in-chronic-thromboembolic-pulmonary-hypertension-following-acute-pulmonary-thromboembolism
#9
J X Xu, H Z Yu, Q Wu, J Mi
Objective: To evaluate the incidence of chronic thromboembolic pulmonary hypertension (CTEPH) secondary to acute pulmonary thromboembolism (PTE) and the serum level of growth differentiation factor-15(GDF-15). Methods: Ninety-six acute PTE patients were recruited in the study. Clinical data, Wells score, blood gas analysis, D-dimmer level, GDF-15 level, atrial and ventricular sizes, pulmonary arterial systolic pressure (PASP) and pulmonary artery CT (CTPA) data were collected. Patients were followed up to evaluate the cardiac function (WHO class), ultrasonic cardiogram and CTPA to confirm the incidence of CTEPH...
November 12, 2016: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/27801920/hydralazine-induced-anca-vasculitis-in-the-setting-of-acute-clostridium-difficile-infection
#10
Somwail Rasla, Amr El Meligy, Dragos F Cucu
We report a rare case of Hydralazine-induced ANCA associated glomerulonephritis with alveolar hemorrhage in the setting of acute Clostridium Difficile Infection. A 71-year-old Caucasian woman with hypertension, who was being treated with hydralazine 25 mg twice a day for six years, presented to the hospital with diarrhea, nausea, vomiting and anemia. She had acute kidney injury and urinalysis showed proteinuria, dysmorphic RBCs, and rare RBC cast. She was found to have Clostridium difficile colitis which was successfully treated...
November 1, 2016: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/27799028/right-heart-catheterization-through-persistent-left-superior-vena-cava-an-extremely-rare-procedure-and-review-of-current-literature
#11
Abdel Rahman Al Emam, Ahmed Abuzaid, Mohammad Chamsi Pasha
Persistent left superior vena cava (PLSVC) is encountered occasionally during angiographic procedures. It usually coexists with right superior vena cava and drains to the right atrium through the coronary sinus, but multiple variations are described. Although PLSVC is extensively reported in the literature, there are very few articles addressing right heart catheterization in patients with isolated PLSVC. We present a patient with absent right superior vena cava and PLSVC draining to a dilated coronary sinus diagnosed during right heart catheterization in the setting of pulmonary hypertension...
October 28, 2016: Current Cardiology Reviews
https://www.readbyqxmd.com/read/27793993/severe-pulmonary-vein-stenosis-resulting-from-ablation-for-atrial-fibrillation-presentation-management-and-clinical-outcomes
#12
Erin A Fender, R Jay Widmer, David O Hodge, George M Cooper, Kristi H Monahan, Laurie A Peterson, David R Holmes, Douglas L Packer
BACKGROUND: The frequency of pulmonary vein stenosis (PVS) after ablation for atrial fibrillation has decreased, but it remains a highly morbid condition. Although treatment strategies including pulmonary vein dilation and stenting have been described, the long-term impacts of these interventions are unknown. We evaluated the presentation of severe PVS, and examined the risk for restenosis after intervention using either balloon angioplasty (BA) alone or BA with stenting. METHODS: This was a prospective, observational study of 124 patients with severe PVS evaluated between 2000 and 2014...
December 6, 2016: Circulation
https://www.readbyqxmd.com/read/27793158/clinical-and-echocardiographic-predictors-of-mortality-in-acute-pulmonary-embolism
#13
Talal Dahhan, Irfan Siddiqui, Victor F Tapson, Eric J Velazquez, Stephanie Sun, Clemontina A Davenport, Zainab Samad, Sudarshan Rajagopal
PURPOSE: The aim of this study was to evaluate the utility of adding quantitative assessments of cardiac function from echocardiography to clinical factors in predicting the outcome of patients with acute pulmonary embolism (PE). METHODS: Patients with a diagnosis of acute PE, based on a positive ventilation perfusion scan or computed tomography (CT) chest angiogram, were identified using the Duke University Hospital Database. Of these, 69 had echocardiograms within 24-48 h of the diagnosis that were suitable for offline analysis...
October 28, 2016: Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/27791952/bronchial-artery-enlargement-may-be-the-cause-of-recurrent-haemoptysis-in-beh%C3%A3-et-s-syndrome-patients-with-pulmonary-artery-involvement-during-follow-up
#14
Sinem Nihal Esatoglu, Emire Seyahi, Serdal Ugurlu, Fatih Gulsen, Canan Akman, Murat Cantasdemir, Furuzan Numan, Hasan Tuzun, Melike Melikoglu, Hasan Yazici, Vedat Hamuryudan
OBJECTIVES: Haemoptysis occurring in a Behçet's syndrome (BS) patient with pulmonary artery involvement (PAI) during follow-up is usually regarded as PAI relapse. However, bronchial artery enlargement (BAE) may be the source of haemoptysis in some patients. METHODS: A chart review at the end of December 2014 revealed 118 patients with PAI in our centre since 1979. Nine (all men) had recurrent haemoptysis during follow-up which could not be explained with relapse of PAI...
September 2016: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/27783043/progressive-vascular-functional-and-structural-damage-in-a-bronchopulmonary-dysplasia-model-in-preterm-rabbits-exposed-to-hyperoxia
#15
Julio Jiménez, Jute Richter, Taro Nagatomo, Thomas Salaets, Rozenn Quarck, Allard Wagennar, Hongmei Wang, Jeroen Vanoirbeek, Jan Deprest, Jaan Toelen
Bronchopulmonary dysplasia (BPD) is caused by preterm neonatal lung injury and results in oxygen dependency and pulmonary hypertension. Current clinical management fails to reduce the incidence of BPD, which calls for novel therapies. Fetal rabbits have a lung development that mimics humans and can be used as a translational model to test novel treatment options. In preterm rabbits, exposure to hyperoxia leads to parenchymal changes, yet vascular damage has not been studied in this model. In this study we document the early functional and structural changes of the lung vasculature in preterm rabbits that are induced by hyperoxia after birth...
October 24, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27776659/ct-pulmonary-angiography-of-adult-pulmonary-vascular-diseases-technical-considerations-and-interpretive-pitfalls
#16
Bedros Taslakian, Larry A Latson, Mylene T Truong, Eric Aaltonen, Maria C Shiau, Francis Girvin, Jeffrey B Alpert, Maj Wickstrom, Jane P Ko
Computed tomography pulmonary angiography (CTPA) has become the primary imaging modality for evaluating the pulmonary arteries. Although pulmonary embolism is the primary indication for CTPA, various pulmonary vascular abnormalities can be detected in adults. Knowledge of these disease entities and understanding technical pitfalls that can occur when performing CTPA are essential to enable accurate diagnosis and allow timely management. This review will cover a spectrum of acquired abnormalities including pulmonary embolism due to thrombus and foreign bodies, primary and metastatic tumor involving the pulmonary arteries, pulmonary hypertension, as well as pulmonary artery aneurysms and stenoses...
November 2016: European Journal of Radiology
https://www.readbyqxmd.com/read/27770513/cytology-diagnosis-of-metastatic-clear-cell-renal-cell-carcinoma-synchronous-to-pancreas-and-metachronous-to-thyroid-and-contralateral-adrenal-report-of-a-case-and-literature-review
#17
Aqiba Bokhari, Patricia G Tiscornia-Wasserman
Renal cell carcinoma metastases to pancreas, thyroid, and contralateral adrenal gland are decidedly uncommon. Clear cell renal cell carcinoma (CCRCC) is the most frequent subtype. Cytology diagnosis may be challenging. A 74-year-old male with remote history of vocal cord malignancy and hypertension presented with abdominal pain. Computed tomography (CT) revealed 8.4 cm left renal mass highly suspicious for renal cell carcinoma, a 1.8 cm mass within vessels near left adrenal and a 2.5 cm mass in pancreatic tail...
October 22, 2016: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/27753873/ish-aha-2-a-case-of-chronic-indolent-pheochromocytoma-which-caused-medically-controlled-hypertension-but-treatment-resistant-diabetes-mellitus
#18
Hae-Young Lee, Chan-Soon Park, Sang-Hoon Na, Kyung-Jin Kim, Chan Joo Lee, Sungha Park
A 47-year-old woman was admitted via emergency department due to dyspnea NYHA Fc II-III aggravated for 2 months after upper respiratory infection. Her height and body weight were 161 cm / 67 kg. Initial vital signs were 110/70 mmHg - 112 BPM - 24/min - 36.5°C. Chest PA showed cardiomegaly and pulmonary congestion (Figure 1). B-natriuretic peptide level was markedly increased (2002 pg/mL, normal range ≤ 100 pg/mL). The echocardiographic examination showed severely dilated LV cavity (61/72 mm) and severe LV systolic dysfunction (EF 28%) with normal left ventricular wall thickness (9/11 mm) (Figure 2)...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27722084/shortness-of-breath-patient-history-not-always-indicative-of-the-cause
#19
Tony S Brar, Neeka Akhavan
This is a 78 year old male with a past medical history of coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), hypertension (HTN), and gastroesophageal reflux disorder (GERD) who presented to the emergency room with worsening shortness of breath (SOB) and low-grade fevers for one week prior to admission. He was originally diagnosed with healthcare associated pneumonia (HCAP) and an acute on chronic COPD exacerbation and treated with prednisone, inhalers, ipratropium/albuterol, and broad-spectrum antibiotics...
2016: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/27719980/imaging-of-pulmonary-hypertension
#20
Christopher J François, Mark L Schiebler
Multimodality, noninvasive imaging is increasingly used in the identification and management of pulmonary hypertension (PH). Chest radiography, ventilation-perfusion scintigraphy, and Doppler echocardiography are frequently the initial studies used to evaluate patients suspected of having PH. However, their ability to evaluate the right ventricle (RV) and pulmonary vasculature is limited. Computed tomography (CT) and magnetic resonance (MR) imaging are increasingly used to identify causes of PH and assess the effect of PH on RV function...
November 2016: Radiologic Clinics of North America
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