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https://www.readbyqxmd.com/read/28918335/modern-diagnosis-of-chronic-thromboembolic-pulmonary-hypertension
#1
Aileen Kharat, Anne-Lise Hachulla, Stéphane Noble, Frédéric Lador
Chronic thromboembolic pulmonary hypertension (CTEPH) should be suspected in patients presenting persistent dyspnea three months after a pulmonary embolism or in patients presenting with acute pulmonary embolism and suggestive images on the CT-scan. For these patients, a specific diagnostic work-up should be performed. First step consists of the ventilation/perfusion (V/Q) scan which is a good screening test due to its high sensitivity and high negative predictive value. Pulmonary angiography remains the gold standard approach for the confirmation of the diagnosis and pre-surgical evaluation of CTEPH...
September 9, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28890877/pulmonary-hypertension-diagnosis-imaging-techniques-and-novel-therapies
#2
REVIEW
Alan B Goldberg, Wojciech Mazur, Dinesh K Kalra
Pulmonary hypertension (PH), defined as the elevation of mean pulmonary arterial pressure (mPAP) above 25 mmHg, has numerous causes, which the World Health Organization (WHO) has divided into five distinct categories based upon the underlying mechanism of action. This review will explore the pathophysiology, diagnostic testing, and treatment of PH. Identification of PH depends on a strong clinical suspicion, a detailed history, and a thorough physical exam. We review the evidence supporting experimental and clinical laboratory parameters for diagnosis and monitoring of PH...
August 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28882938/imatinib-dramatically-alleviates-pulmonary-tumour-thrombotic-microangiopathy-induced-by-gastric-cancer
#3
Kana Kubota, Taro Shinozaki, Yasushi Imai, Kazuomi Kario
Pulmonary tumour thrombotic microangiopathy (PTTM) is a rare complication of cancer, which can be lethal due to progressive pulmonary hypertension (PH). Several case reports have demonstrated that imatinib, a platelet-derived growth factor receptor-tyrosine kinase inhibitor, can improve severe PH in patients with PTTM.We describe the case of a 56-year-old woman. Her mean pulmonary arterial pressure (mPAP) was 47 mm Hg, and her dyspnoea worsened rapidly over several days. Although pulmonary embolism was not observed on CT, enlargement of the para-aortic lymph nodes was detected...
September 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28862244/isolated-left-sided-pulmonary-artery-agenesis-with-left-lung-hypoplasia-a-report-of-two-cases
#4
V Govindaraj, J Joseph, B Nagamalli Kumar, R Soman
Unilateral absence of pulmonary artery or pulmonary artery agenesis (UAPA) is a rare congenital malformation that can present as an isolated lesion or in association with other cardiac anomalies. Though congenital, presentation in adults are also reported. Most common presentation in adults is of exercise intolerance. The developing lung on the affected side is hypoplastic. Diagnosis of UAPA is established by imaging methods like CT and MRI . There is no specific treatment for this condition. Treatment depends on patients symptomatology, presence of pulmonary hypertension and collateral circulation...
August 31, 2017: Journal of Postgraduate Medicine
https://www.readbyqxmd.com/read/28857335/comparison-of-a-computed-tomographic-pulmonary-trunk-to-aorta-diameter-ratio-with-echocardiographic-indices-of-pulmonary-hypertension-in-dogs
#5
James Sutherland-Smith, Elyshia J Hankin, Suzanne M Cunningham, Amy F Sato, Bruce A Barton
There are limited criteria for the detection of pulmonary hypertension in dogs undergoing computed tomography (CT) for pulmonary disease. This retrospective analytical exploratory study compared a CT pulmonary trunk to aorta ratio with echocardiographic estimates of pulmonary hypertension. Dogs having both a contrast thoracic CT and echocardiogram were selected and maximal pulmonary trunk and descending aorta diameters were measured by two observers on a single transverse CT image. Computed tomographic diameter ratios were compared with the echocardiographic parameters of tricuspid regurgitation gradient, right ventricular acceleration time-to-ejection time ratio, pulmonary insufficiency gradient, and pulmonary artery to aorta diameter...
August 30, 2017: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/28856715/feasibility-of-quantitative-regional-ventilation-and-perfusion-mapping-with-phase-resolved-functional-lung-preful-mri-in-healthy-volunteers-and-copd-cteph-and-cf-patients
#6
Andreas Voskrebenzev, Marcel Gutberlet, Filip Klimeš, Till F Kaireit, Christian Schönfeld, Alexander Rotärmel, Frank Wacker, Jens Vogel-Claussen
PURPOSE: In this feasibility study, a phase-resolved functional lung imaging postprocessing method for extraction of dynamic perfusion and ventilation parameters using a conventional 1H lung MRI Fourier decomposition acquisition is introduced. METHODS: Time series of coronal gradient-echo MR images with a temporal resolution of 288 to 324 ms of two healthy volunteers, one patient with chronic thromboembolic hypertension, one patient with cystic fibrosis, and one patient with chronic obstructive pulmonary disease were acquired at 1...
August 30, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28845401/the-role-of-nt-probnp-in-the-diagnosis-of-ventricular-arrhythmias-in-patients-with-systemic-sclerosis
#7
Lucian Muresan, Ana Petcu, Crina Muresan, Mirela Rinzis, Gabriel Gusetu, Dana Pop, Dumitru Zdrenghea, Simona Rednic
BACKGROUND: In patients with systemic sclerosis, NT-proBNP is a useful diagnostic marker for pulmonary hypertension and ventricular dysfunction, with important prognostic significance. The aim of this study was to assess the relationship between the NT-proBNP levels and the presence and severity of ventricular arrhythmias in patients with scleroderma. METHODS: Forty consecutive patients with a diagnostic of systemic sclerosis according to the EULAR criteria admitted at the Rheumatology Clinic of Cluj-Napoca, Romania, from Jan 2014 to Apr 2014 were enrolled...
July 2017: Iranian Journal of Public Health
https://www.readbyqxmd.com/read/28837121/diagnostic-approach-to-pulmonary-hypertension-in-premature-neonates
#8
REVIEW
Vasantha H S Kumar
Bronchopulmonary dysplasia (BPD) is a form of chronic lung disease in premature infants following respiratory distress at birth. With increasing survival of extremely low birth weight infants, alveolar simplification is the defining lung characteristic of infants with BPD, and along with pulmonary hypertension, increasingly contributes to both respiratory morbidity and mortality in these infants. Growth restricted infants, infants born to mothers with oligohydramnios or following prolonged preterm rupture of membranes are at particular risk for early onset pulmonary hypertension...
August 24, 2017: Children
https://www.readbyqxmd.com/read/28795035/aortopulmonary-fistula-presenting-without-an-endoleak-after-thoracic-endovascular-aortic-repair
#9
Giacomo Sica, Gaetano Rea, Giorgio Bocchini, Romilda Lombardi, Massimo Muto, Tullio Valente
Herein, we report the case of a 60-year-old man, a smoker with a history of arterial hypertension and diabetes mellitus. After computed tomography (CT) for an episode of hemoptysis, the patient underwent elective thoracic endovascular aortic repair (TEVAR) because of a degenerative aneurysm of the descending thoracic aorta. The area of perianeurysmal pulmonary atelectasis reported on the CT scan was not considered. Three months later, he developed an aortopulmonary fistula without endoleaks. Although TEVAR is a relatively safe procedure, no detail should be overlooked in the preoperative evaluation in order to avoid life-threatening complications...
August 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28794091/a-rare-cause-of-early-neonatal-cyanosis-absent-right-pulmonary-artery
#10
Avadhesh Joshi, Manish Kumar, Sumitha Arun, Mane Manisha Sheshrao
Unilateral absent right pulmonary artery is a rare developmental anomaly that usually presents in late childhood and adolescence as recurrent respiratory tract infections, dyspnoea and haemoptysis. We report a case of a 2-day-old baby with respiratory distress and differential cyanosis. Echocardiogram showed pulmonary hypertension with absent right pulmonary artery. The findings were confirmed by CT angiogram. The baby improved with pulmonary vasodilators and antifailure medications.
August 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28763468/predictors-of-lung-function-test-severity-and-outcome-in-systemic-sclerosis-associated-interstitial-lung-disease
#11
Noémie Le Gouellec, Alain Duhamel, Thierry Perez, Anne-Lise Hachulla, Vincent Sobanski, Jean-Baptiste Faivre, Sandrine Morell-Dubois, Marc Lambert, Pierre-Yves Hatron, Eric Hachulla, Hélène Béhal, Regis Matran, David Launay, Martine Remy-Jardin
Systemic sclerosis-related interstitial lung disease (SSc-ILD) is the leading cause of death in SSc. In this study, we aimed to describe the baseline severity and evolution of forced vital capacity (FVC) and diffusing capacity for carbon monoxide (DLCO) in patients with SSc-ILD and to assess the baseline clinical, biological and high-resolution CT scan (HRCT) predictors of this evolution. Baseline and serial FVC and DLCO were collected in 75 SSc-ILD patients followed during 6.4±4.2 years (n = 557 individual data)...
2017: PloS One
https://www.readbyqxmd.com/read/28728932/the-complex-restrictive-pulmonary-function-pattern-clinical-and-radiologic-analysis-of-a-common-but-previously-undescribed-restrictive-pattern
#12
Ryan D Clay, Vivek N Iyer, Dereddi Raja Reddy, Brittany Siontis, Paul D Scanlon
BACKGROUND: Most patients with restriction have a pulmonary function test (PFT) pattern in which total lung capacity (TLC), FVC, and FEV1 are reduced to a similar degree. This pattern is called "simple restriction" (SR). In contrast, we commonly observe a pattern in which FVC percent predicted (pp) is disproportionately reduced relative to TLCpp. This pattern is termed "complex restriction" (CR), and we attempted to characterize its clinical, radiologic, and physiologic features. METHODS: This study reviewed PFT results of patients tested between November 2009 and June 2013 who had restriction (TLC less than the lower limit of normal)...
July 17, 2017: Chest
https://www.readbyqxmd.com/read/28701673/pulmonary-artery-diameter-predicts-lung-injury-after-balloon-pulmonary-angioplasty-in-patients-with-chronic-thromboembolic-pulmonary-hypertension
#13
Koichi Sugimoto, Kazuhiko Nakazato, Nobuo Sakamoto, Takayoshi Yamaki, Hiroyuki Kunii, Akiomi Yoshihisa, Hitoshi Suzuki, Shu-Ichi Saitoh, Yasuchika Takeishi
Balloon pulmonary angioplasty (BPA) has been an attractive strategy for chronic thromboembolic pulmonary hypertension (CTEPH), even though it occasionally causes lung injury. However, predictive factors of lung injury after BPA have not been established. Pulmonary artery (PA) dilatation is often observed in patients with pulmonary hypertension. We investigated the association between PA diameter and complications after BPA.The subjects were 19 CTEPH patients who underwent BPA. Patients were divided into two groups: patients with lung injury including asymptomatic lung infiltration on computed tomography (CT) images or mild hemoptysis (group L, n = 9) and no complications (group N, n = 10)...
August 3, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28666564/the-dilatation-of-main-pulmonary-artery-and-right-ventricle-observed-by-enhanced-chest-computed-tomography-predict-poor-outcome-in-inoperable-chronic-thromboembolic-pulmonary-hypertension
#14
Ryogo Ema, Toshihiko Sugiura, Naoko Kawata, Nobuhiro Tanabe, Hajime Kasai, Rintaro Nishimura, Takayuki Jujo, Ayako Shigeta, Seiichiro Sakao, Koichiro Tatsumi
BACKGROUND: Dilatation of the pulmonary artery and right ventricle on chest computed tomography images is often observed in patients with pulmonary hypertension. The clinical significance of these image findings has not been defined in chronic thromboembolic pulmonary hypertension. We investigated whether the pulmonary arterial and right ventricle dilatation was associated with poor outcome in chronic thromboembolic pulmonary hypertension. METHODS: This was a retrospective cohort investigation in 60 subjects with inoperable chronic thromboembolic pulmonary hypertension diagnosed consecutively between 1997 and 2010 at Chiba University Hospital...
June 12, 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28648001/-ct-findings-and-clinical-features-of-takayasu-s-arteritis-with-pulmonary-artery-involvement
#15
R Lü, C L Yu, J Li, D D Wen, M W Zheng
Objective: To explore the CT findings of the Takayasu's arteritis (TA)with pulmonary artery (PA) involvement and its clinical significance. Methods: A total of 35 patients with TA involving the PA in Xijing Hospital from November 2007 to November 2016, 6 male cases, 29 female cases, the age was 15-52 (28±9) years old, were retrospectively collected and included in the study group (TA+ P group), meanwhile 40 patients with TA but not involving the pulmonary artery in this hospital from January 2015 to November 2016 were collected as control group, 5 male cases, 35 female cases, the age was 7-67 (28±12) years old...
June 20, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28647630/endovascular-repair-of-iatrogenic-iliocaval-fistula-causing-high-output-cardiac-failure-after-spine-fusion
#16
Seth Noland, Carlos A Espinoza, Jonathan D Dvorak, John D Rose, C Steven Powell
The case being presented is a 35-year-old female with a 3-year history of progressive dyspnea and right-sided heart failure following spine surgery. Physical examination identified a continuous bruit in the lower abdomen radiating to her back which prompted further evaluation. Echocardiography showed normal left ventricle systolic function, enlarged right ventricle, functional tricuspid regurgitation, and moderate pulmonary hypertension. A computed tomography (CT) scan of the abdomen and pelvis demonstrated findings consistent with an arteriovenous fistula (AVF) between the right common iliac artery and the inferior vena cava...
June 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28619955/pulmonary-artery-to-aorta-ratio-and-risk-of-all-cause-mortality-in-the-general-population-the-rotterdam-study
#17
Natalie Terzikhan, Daniel Bos, Lies Lahousse, Lennard Wolff, Katia M C Verhamme, Maarten J G Leening, Janine F Felix, Henning Gall, Hossein A Ghofrani, Oscar H Franco, M Arfan Ikram, Bruno H Stricker, Aad van der Lugt, Guy Brusselle
A pulmonary artery to aorta ratio (PA:A) >1 is a proxy of pulmonary hypertension. It is not known whether this measure carries prognostic information in the general population and in individuals with chronic obstructive pulmonary disease (COPD).Between 2003 and 2006, 2197 participants from the population-based Rotterdam Study (mean±sd age 69.7±6.7 years; 51.3% female), underwent cardiac computed tomography (CT) scanning with PA:A quantification, defined as the ratio between the diameters of the pulmonary artery and the aorta...
June 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28597764/microct-analysis-of-vascular-morphometry-a-comparison-of-right-lung-lobes-in-the-sugen-hypoxic-rat-model-of-pulmonary-arterial-hypertension
#18
Erin M Faight, Kostas Verdelis, Lee Zourelias, Rong Chong, Raymond L Benza, Kelly J Shields
Pulmonary arterial hypertension (PAH) is a rare disease characterized by significant vascular remodeling within the lung. Clinical computed tomography (CT) scans are routinely used to aid in PAH diagnosis. Animal models, including the Sugen-hypoxic rat model (SU/hyp), of PAH closely mimic human PAH development. We have previously used micro-computed tomography (microCT) to find extensive right lung vascular remodeling in the SU/hyp. We hypothesized that the individual right lung lobes may not contribute equally to overall lung vascular remodeling...
April 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28597752/withdrawal-of-long-term-epoprostenol-therapy-in-pulmonary-arterial-hypertension-pah
#19
George Calcaianu, Mihaela Calcaianu, Matthieu Canuet, Irina Enache, Romain Kessler
Once initiated for pulmonary arterial hypertension (PAH), epoprostenol treatment usually needs to be delivered for an indefinite duration. It is possible that some participants could be transitioned from epoprostenol to oral therapies. We retrospectively evaluated eight PAH participants transitioned from epoprostenol to PAH oral drugs. The criteria for epoprostenol withdrawal were: (1) persistent improvement of clinic and hemodynamic status; (2) stable dose of epoprostenol for the last three months; and (3) the participant's preference for oral therapy after evaluation of risk-benefit...
April 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28576625/detection-of-mechanical-complications-related-to-the-potential-risk-of-sudden-cardiac-death-in-patients-with-pulmonary-arterial-hypertension-by-computed-tomography
#20
Sang-Eun Lee, Ji Hyun Im, Ji Min Sung, In-Jeong Cho, Chi Young Shim, Geu-Ru Hong, Namsik Chung, Jo Won Jung, Hyuk-Jae Chang
BACKGROUND: We explored the value of cardiac computed tomography (CT) for the detection and prediction of mechanical complications related to the risk of sudden cardiac death (SCD) in pulmonary arterial hypertension (PAH) patients. METHODS: PAH patients (n=60, mean age 47±15, 31.7% male) with pulmonary artery (PA) enlargement (≥40mm) by echocardiography were studied with cardiac CT. Complications explored were the presence of left main coronary artery (LM) compression, airway compression, PA dissection and PA thrombosis in relation to diameters of main PA (MPA) which were measured in (1) axial plane (MPAAx) and (2) LM oblique view (MPALMobq)...
September 15, 2017: International Journal of Cardiology
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